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Hospital Circular 28 /2005

Date Issued: 28 December 2005

Distribution: Chief Executive Officers: Health Services and Private Hospitals Chief Executive Officers: Ambulance Services

Subject: Non-Emergency Patient Transport Regulations 2005

Purpose: To provide advice on the implications of the Non-Emergency Patient Transport (NEPT) Regulations 2005 for all hospitals, including hospitals that contract non-emergency patient transport services or operate non-emergency transport services.

Background

You were advised in Hospital Circular 35/2003 of the passing of the Non Emergency Patient Transport Act 2003 (the Act) which provided for the development of regulations to set minimum standards for non-emergency patient transports. The Act requires that, as of 1 February 2006, all NEPT services must be licensed in order to be able to transport patients in Victoria.

Significant consultation with the industry has occurred on the development of the standards, including health services as one of the key stakeholders.

The Non Emergency Patient Transport Regulations 2005

Regulations under the Act have now been made and apply to all NEPT services that offer or provide for the transport of persons on public roads (or air) to or from medical services (including those provided by ambulance services and transport services operated by hospitals):

(i) using a stretcher carrying vehicles; or

(ii) where the persons being transported are provided with specialist clinical care, or monitoring, whilst being transported.

Ambulance services, public hospitals or denominational hospitals that operate patient transport services are exempted under the Act, section 5 (2), from applying for a license.

The Regulations cover the following areas:

• Classes of NEPT Services - three levels of acuity are defined: low, medium and high, for both road and air transport. It is these levels of acuity that define which level of service and the skill of the crew that is required to transfer patients.
• Staffing, including the minimum number of staff required for specified types of transports, as well as requirements as to their qualifications and clinical accreditation.
• Licensing and quality accreditation.
• Stand-by services at public events.
• Records.
• Patient Rights and Information.
• Infection Control.
• Provision, Inspection and Maintenance of Vehicles and Equipment.
• Insurance.
• Clinical Practice Protocols.
• Aeromedical services.

The key benefit of the Regulations for health services is the level of independent accreditation of private patient transport providers to standards in the areas outlined above. This should assist in the tendering for services contracted directly by hospitals.

I consider that the Non-Emergency Patient Transport Regulations 2005 have achieved an excellent balance between quality, safety and cost. All classes of NEPT services will now be provided at a consistent and appropriate level of quality across the State.

A copy of the Act, Regulations and Clinical Practice Protocols is available at http://www.health.vic.gov.au/nept/

Authorisation of transports by a medical practitioner

Publicly funded ambulance services currently provide all non-chargeable non-emergency patient transports. I would like to take this opportunity to remind health services that the provision of non-emergency patient transport by the Ambulance Services is expensive and should only be used when it is necessary for a patient's medical condition. Non-emergency patient transport needs to be authorised by a medical practitioner , who has assessed the patient's clinical condition using the criteria outlined in the Regulations. DHS has encouraged the Metropolitan Ambulance Service and Rural Ambulance Victoria to regularly review these authorisations.

It should be noted that while there is also a demand for transport related to "social" rather than clinical need or mobility factors, it is not appropriate to use publicly funded ambulance services for this purpose, and other forms of transport (for example, taxi) should be used.

Responsibility for the licensing system

The Department of Human Services' Private Hospitals Unit (PHU) is responsible for administering the licensing system for non-emergency patient transport services and reviewing any complaints about lack of compliance with the regulations. The PHU is currently undertaking inspections of NEPT providers with a view to ensuring that all license applications can be considered before 1 February 2006. A list of licensed providers will be publicly accessible on the NEPT website from 1 February 2006.

Please contact Marion Place, Manager - Private Hospitals Unit, 9616 2167 for any further information about the regulations or licensing system.

Lea Pope
Acting Director, Programs
Metropolitan Health & Aged Care Services