Non-Emergency Patient Transport (NEPT)
Non-emergency patient transport or NEPT is available for patients who do not require a time critical ambulance response and who have been assessed by a medical practitioner.
Most NEPT transfers occur between hospitals and between home and hospital. Many nursing home patients are transported by NEPT to and from specialist health appointments and rehabilitation. The majority of non-emergency transports are provided by road, with a small number undertaken by air services.
Non-emergency patient transports need to be authorised by a medical practitioner. Authorisation considers whether there is a demonstrated medical requirement for ambulance transport on the grounds that:
- the patient requires the use of the specialised equipment contained within the vehicle, or
- the patient requires the skill levels and qualifications of staff on either an ambulance vehicle or on a non-emergency patient transport vehicle
- a patient has an illness or a disability that makes it impractical to use any other form of transport, for example, severe immobility or disorientation.
NEPT services play an important role in supporting health service access and high quality patient care. In recognition of this, the Victorian Coalition Government has commissioned a study of Victorias NEPT sector.
Allens Consulting has been engaged to undertake this study and is nearing the completion of a final report.
NEPT Regulations & Clinical Practice Protocols
The Department of Health is responsible for the development and implementation of:
Non-Emergency Patient Transport Act 2003 - available from the Victorian Legislation and Parliamentary Documents website.
Non-Emergency Patient Transport Regulations 2005 - available from the Victorian Legislation and Parliamentary Documents website.
The NEPT Clinical Practice Protocols are for use by licensed NEPT providers for the triage and care of patients during non emergency transport and when providing first aid services at public events. The department is currently in the process of reviewing the protocols. A revised version of the protocols will be ready for publication later in 2011.
Licensed NEPT providers can also provide First Aid stand by at public events. The stand-by services Frequently Asked Questions are designed to provide advice and clarification for event managers in Victoria wanting to provide first aid stand-by services at their events.
Please contact the Policy Instruments and Compliance Unit if you require further general information regarding the Non-Emergency Patient Transport Act 2003, the NEPT Regulations or the Clinical Practice Protocols in Victoria.
Telephone: (61 3) 9096 2164
Fax: (61 3) 9096 9196
Patient acuity is now being captured as part of the NEPT booking process in the metropolitan region. From 1 June 2011, bookings for non emergency transport must include the following information:
- Details of the patient acuity, consistent with the NEPT Regulations 2005;
- Additional information regarding patient weight; and
- Patient mobility aids or other equipment.
It is important that health professionals are familiar with patient acuity as this information is now mandatory when requesting patient transport.
Full definitions of patient acuity can be found in the Non-Emergency Patient Transport Regulations 2005 (available from the Victorian Legislation and Parliamentary Documents website) and the Non-emergency patient transport: Clinical practice protocols. A general guide is provided below.
Low-acuity patients don’t require active treatment but have an illness or injury that needs supervision during their transport.
Examples of low-acuity patients
- inability to travel in a normal seated position
- requirement for oxygen during transport
- impaired cognitive function
- inability to travel more than a few steps unaided
Low-acuity patients need to have been assessed by an Appropriate Health Professional as stable for the duration of the transport and have no emergency clinical symptoms (page 9) of the Clinical Practice Protocols.
Appropriate Health Professional
- A medical practitioner with knowledge of the patient
- A Division 1 registered nurse who has examined the patient
- A paramedic working for Ambulance Victoria in the communications department
- A paramedic or registered nurse working for Ambulance Victoria in telephone triage
Medium-acuity patients have an illness or injury which requires active monitoring and/or management.
Examples of Medium-acuity patients
Patients may require at least one of the following:
- cardiac monitoring
- observation and monitoring of an intravenous infusion of a crystalloid fluid, with or without an infusion pump
- observation and monitoring of an intravenous infusion of crystalloid fluid containing glyceryl trinitrate or heparin using (an) infusion pump(s)
- care of an intercostal catheter or central venous catheter
- care of the patient who has a recent fracture of the spinal column (without spinal cord injury)
- care of the patient on home ventilation
Medium acuity patients need to have been assessed by a medical practitioner as haemodynamically stable for the duration of the transport and have no emergency clinical symptoms or potential need for transport under emergency conditions.
High-acuity patients have an illness or injury which requires active monitoring or treatment by a nurse or medical practitioner.
Examples of High-acuity patients
Patients may have or require at least one of the following:
- mechanical ventilation
- an intravenous infusion of a vasoactive drug
- a patient with tracheostomy
- a patient with a central or arterial line
- a device which supports the circulation (intra-aortic balloon pump or extra-corporeal membrane oxygenation)
High-acuity patients need to have been assessed by a referring medical practitioner as haemodynamically stable for the duration of the transport and have no emergency clinical symptoms or potential need for transport under emergency conditions.