The Council of Ambulance Authorities (CAA) is a not-for-profit national charity and operates as the peak body for the Australian, New Zealand and Papua New Guinea ambulance sectors.
The CAA works tirelessly to collaborate on ambulance and pre-hospital issues of metropolitan, regional, national, and international significance. We stand alongside ambulance services, healthcare professionals and researchers to build community awareness and foster new thinking in patient centred care by ambulance healthcare services.
The CAA was set up in 1962 with the aim to provide ambulance service CEOs a networking opportunity to discuss issues, learnings and achievements current to the pre-hospital industry.
Today’s CAA takes the leading role in the Ambulance sector by advocating for continuous improvement in service delivery and patient outcomes. This is done by engaging stakeholders to ensure sustainable funding, providing forums for members to collaborate and share information, ideas and experiences and developing programmes to grow and develop the next generation of Ambulance Sector leaders.
2023-24 has been characterised by notable progress and development for the CAA and its members across a diverse range of circumstances. This advancement underscores the organisation’s dedication to enhancing and effectively responding to the evolving demands of the sector.
As the Chair for CAA, I am pleased to present the Annual Report for the 2023-2024 fiscal year. This report highlights our achievements, challenges, and ongoing commitment to supporting our members in delivering exceptional ambulance services across Australia and New Zealand.
The past year has been one of significant progress and adaptation for the ambulance sector. The CAA has continued to play a crucial role in fostering collaboration, sharing best practices, and advocating for the advancement of ambulance services.
The CAA have organised several key events to support and advance the ambulance sector including Australasia’s premier event, Congress, held in Brisbane in 2023, Women in Leadership Symposium, Restart a Heart Day across the country plus several webinars and other key campaigns to build on the education and networking for the sector. These focused sessions allow for in-depth exploration of critical issues facing ambulance services
CAA Group meetings and committees continue to provide an invaluable opportunity to foster collaboration and innovation within our sector. This ensures and maintains that all our services are at the forefront of industry standards and practices. We remain committed to driving positive and supportive change throughout our communities.
We are very lucky to have a data and research team who’ve been very active in conducting the various reports and surveys throughout the year from our services. This fiscal year we have seen a number of important and diverse reports produced including the Workforce and Gender Report, Patient Experience Survey and this year, a milestone for the industry, with the announcement of the Sustainability White Paper which will become an industry benchmark when it comes to the ambulance sector.
Along with our key activities and team members, The CAA has made significant strides in advancing our five-year strategic plan, focusing on three key pillars:
• Advocacy: We’ve strengthened our role as the unified voice for the ambulance sector, providing support and guidance on service delivery matters.
• Knowledge & Information: We’ve facilitated connections and idea exchanges across borders, fostering strong relationships within the sector.
• Learning & Development: We’ve collaborated with universities and member services to enhance education and training programs for ambulance professionals.
As we move forward, the CAA remains committed to supporting our members and driving positive change in the ambulance sector. We’ll continue to focus on workforce development, sustainability, and enhancing our services to meet the evolving needs of our communities.
I’m proud of our progress this year and look forward to building on these achievements in the coming fiscal year.
Howard Wren CAA Chair and Board Member
As Chief Executive of The Council of Ambulance Authorities, I am excited to share with you the 2023-2024 Annual Report.
Another year is in the books, and I am thrilled to showcase the incredible work that takes place across the Australasian Ambulance Sector. The phenomenal work of our member services must be highlighted with some incredible figures that have been collated. Member services attended 4,963,220 incidents, travelled over 158,800,000 kilometres, had a patient total of 4,593,991 with an astounding satisfaction rate of 98%.
Throughout our 2024 Annual Report, you will learn about the incredible and vast range of work and activities that have taken place including:
• Highlights from an incredible year of important service from our 11 members services.
• A summary of the discussions that take place across the various Forums, Committees and Groups
• The incredible work driven by the MARCOMMS team across their campaigns.
• An overview of CAA Congress held in Brisbane including the winners of the Awards for Excellence and Star Award.
• The growth of readership and topics in the 2023-2024 editions of first magazine.
• Another successful Restart A Heart Day campaign highlighting and leading the way in the learnings of CPR and use of the life-saving AED.
• The inaugural Women in Leadership Forum where we awarded the second Women in Leadership Scholarship.
To the teams across our services, without your tireless efforts in every aspect of the Ambulance sector, we would not be able to report on the fantastic outcomes from each, each year. So again, thank you.
I encourage you to progress through the coming pages to reflect on what was a fantastic 2023-2024 for the CAA and its member services across many platforms, activities and campaigns.
David Waters Chief Executive
Together, we can continue to develop the sector and this is essential for enhancing patient care while adapting to the dynamic challenges of modern healthcare.
the year ended 30 June 2024
Statement of Financial Position
as at 30 June 2024
Opinion
We have audited the financial report of The Council of Ambulance Authorities Inc (“the Association”), which comprises the statement of financial position as at 30 June 2024, the statement of profit or loss and other comprehensive income, the statement of changes in equity and the statement of cash flows for the year then ended, and notes to the financial statements, including material accounting policy information, and the Board Members declaration.
In our opinion, the financial report of the Association has been prepared in accordance with Division 60 of the Australian Charities and Not-for-profits Commission Act 2012, including:
(a) giving a true and fair view of the Association’s financial position as at 30 June 2024 and of its financial performance for the year ended; and
(b) complying with Australian Accounting Standards to the extent described in Note 1, and Division 60 of the Australian Charities and Not-for-profit Commission Regulation 2022.
Basis for Opinion
We conducted our audit in accordance with Australian Auditing Standards. Our responsibilities under those standards are further described in the Auditor’s Responsibilities for the Audit of the Financial Report section of our report. We are independent of the Association in accordance with the auditor independence requirements of the Australian Charities and Not-for-profits Commission Act 2012 (ACNC Act) and the ethical requirements of the Accounting Professional and Ethical Standards Board’s APES 110 Code of Ethics for Professional Accountants (including Independence Standards) (the Code) that are relevant to our audit of the financial report in Australia. We have also fulfilled our other ethical responsibilities in accordance with the Code.
We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.
Emphasis of Matter - Basis of Accounting
We draw attention to Note 1 to the financial report, which describes the basis of accounting. The financial report has been prepared for the purpose of fulfilling the Association’s financial reporting responsibilities under the ACNC Act. As a result, the financial report may not be suitable for another purpose. Our opinion is not modified in respect of this matter.
Responsibilities of Board Members for the Financial Report
The Board Members of the Association are responsible for the preparation of the financial report that gives a true and fair view and have determined that the basis of preparation described in Note 1 to the financial report is appropriate to meet the requirements of the ACNC Act and the needs of the members. The Board Members’ responsibility also includes internal control as the directors determine is necessary to enable the preparation of the financial report that gives a true and fair view and is free from material misstatement, whether due to fraud or error.
In preparing the financial report, the Board Members are responsible for assessing the Association’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the Board Members either intend to liquidate the Association or to cease operations, or has no realistic alternative but to do so.
The Board Members of the Association are responsible for overseeing the Association’s financial reporting process.
Auditor’s Responsibilities for the Audit of the Financial Report
Our objectives are to obtain reasonable assurance about whether the financial report as a whole is free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with the Australian Auditing Standards will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of this financial report.
A further description of our responsibilities for the audit of the financial report is located at the Auditing and Assurance Standards Board website at: https://www.auasb.gov.au/auditors_ responsibilities/ar4.pdf. This description forms part of our auditor’s report.
Robyn Speed Director- Audit and Assurance
12 November 2024
Today, CAA represents eleven statutory ambulance service providers across Australasia and works with associations and partners across the ambulance, emergency management and health sectors.
The CAA is the peak advocacy body that represents a combined workforce of 48,000 paramedics, patient transfer officers, volunteers, communications staff, corporate teams, students, and leaders. These world class trained teams are committed to looking after patients across all of Australasia.
26,642 Salaried Staff
10,481 Volunteers and First Responders
4.6 million Patients
98% Overall Patient Satisfaction
1,865 Ambulance Stations and Locations
8,129 Ambulances and Other Vehicles
86 Aircraft (excludes New Zealand)
158 million Kilometres Travelled
ACT Ambulance Service
The ACT Ambulance Service (ACTAS) implemented a new frontline emergency operations roster in April 2024. The new roster increases ambulance resources for the peak workload demand as well as improving staff wellbeing through reducing fatigue and regular access to meal breaks and on-shift professional development time.
ACTAS is also increasing its alternative services to the community. The Extended Care Paramedic program is staffed by paramedics with additional training and equipment to allow them to manage a wider range of patients in the community, reducing the need for transport to hospital.
The ACT Government has invested in remote training, specialised equipment and the commissioning of a new purpose built 4WD vehicle to support remote area operations, delivering better outcomes for our patients. The ACTAS Remote Access Paramedic team works collaboratively with our Emergency Services colleagues and ACT Policing in providing access to out of hospital medical care in austere environments to residents and visitors to the ACT.
In addition to the new frontline emergency operations roster, ACTAS introduced the Secondary Triage System (STS) into the E000 Communications Centre (ComCen) this year. The STS will enable ACTAS to undertake secondary telephone triage by reliably, safely, rapidly, and accurately identifying patient’s clinical needs and matching their needs to suitable clinical services. It allows triple zero calls identified as potentially not requiring an emergency response to be more appropriately managed.
ACTAS has established a Consumer Advisory Group consisting of people who represent the interests of health consumers. The establishment of this group represents ACTAS’ commitment to make our consumers the centre of all that we do. A commitment to lived experience, person centred care, opinion and input. We currently have 12 members with representatives that include the Health Care Consumers Association, ACT Mental Health Consumer Network, Asthma Australia, Meridian, Multicultural Forum members and Canberra Alliance for Harm Minimisation and Advocacy. The group also consists of members who have cared for a consumer, or actively used ACTAS services themselves.
This group will drive ACTAS’ business, operational and strategic decisions to be truly influenced and based on the perspective of those who ACTAS provide care to every day. The group will be consulted on issues like website access, communication, service delivery, complaint process and care planning for consumers with complex care needs. This will provide valuable information and input to drive the development of future quality improvement projects. With a busy workplan on a myriad of issues, ACTAS looks forward to actively working with our consumers to truly tailor our service to each person we attend and ensure that all we do is based on lived experience and input.
Ambulance Tasmania
Ambulance Tasmania continues to grow as an organisation with a focus on delivering excellent out-of-hospital care
to Tasmanians.
In October 2023, the Tasmanian Government Radio Network (TasGRN) went live across the State - a major initiative that brought eight core response agencies, including Tasmania Police and the Tasmania Fire Service, onto one unified digital radio network. This new technology and radio handsets have significantly enhanced our emergency services and government agency communications.
In November 2023, the Ambulance Tasmania Online Medication System (ATOMS) for specified medications (controlled drugs) was implemented. ATOMS replaces paper-based medication registers and provides capacity for auditing of all aspects of medication management.
In 2023-24, we strengthened our senior leadership team with the appointment of Michelle Baxter as Executive Director of Operations (commencing February 2024), Jennifer Bolster as Director of Clinical Services and Katrina Ostrenski as Director of Education (both commencing in March 2024).
In March 2024, Ambulance Tasmania implemented a new protocol to reduce transfer of care delays across Tasmania’s four major hospitals. The protocol requires all patients arriving by ambulance to be transferred to the care of Emergency Department staff within 60 minutes. The protocol has resulted in significant positive changes – in January 2024, 69% of cases were offloaded within 60 minutes statewide compared to 80% in June 2024. Within that same period, the average time at hospital dropped from 54 minutes to 45 minutes.
Other achievements have included commencement of a Mental Health Emergency Response (MHER) unit in the North West (November 2023), and launching Ambulance Tasmania’s partnership with GoodSAM in June 2024, an internationally recognised platform that alerts and dispatches nearby responders to cardiac arrest incidents.
Ambulance Tasmania commenced its journey towards readiness for accreditation under the National Safety and Quality Health Service (NSQHS) Standards, with the first readiness assessment completed in July 2024. This assessment will inform a roadmap for Ambulance Tasmania to successfully meet the requirements of the NSQHS Standards in the next two years.
In 2023-24, new ambulance stations opened in the Greater Hobart suburb of Bridgewater, Queenstown on the State’s West Coast and Beaconsfield in the North East. Construction began on stations in Glenorchy in Greater Hobart, Burnie on the North West Coast and Oatlands in central Tasmania, with completion of these projects expected in the second half of 2024.
To finish the financial year Ambulance Tasmania’s Strategic document, Our Future: 2024 – 2027, was finalised in June 2024, providing clear direction to guide organisational business planning and activities over the next three financial years, focusing on Our Patients, Our Performance, Our Performance and Our Partnerships.
At Ambulance Victoria (AV) we are incredibly proud of the unique and trusted role we play in serving our community.
In 2023-2024 we launched our Strategic Plan 2023–2028: Transforming for Better. The plan defines our core purpose to bring world-leading, patient-focused, out-of-hospital, mobile and emergency health care to Victorians.
We also co-designed new organisational valuesCare, Accountability, Respect and Excellence - to create a shared understanding of who we are, what we stand for, and how we act. Our focus remains on creating a safe, fair and inclusive workplace, and we have made significant progress against the 43 recommendations from the Victorian Equal Opportunity and Human Rights Commission review into our workplace culture. While we still have more to do, we have come a long way in building the foundations for long-term, systemic, sustainable change.
Victoria has the most registered paramedics in Australia, and we continue to recruit to ensure we can respond to the needs of our community. In our biggest roster reform in 50 years, we implemented People Based Rostering in several metropolitan areas to reduce fatigue and improve work-life balance for our people while aligning with operational demand.
Our dedication to clinical excellence drives us to continuously innovate and improve as we respond to record demand. From state-of-the-art retrieval services and a groundbreaking cardiac arrest strategy to comprehensive educational programs and international partnerships, our clinical advancements are at the national forefront of transforming healthcare. We meet or exceed all our patient quality and care measures, leading to better outcomes in the survival and quality of life for heart attack, stroke and trauma patients.
In an Australasian first, we introduced Video Assisted Triage which allows Triage Practitioners to both see and hear patients – providing a more accurate assessment of their condition and improving their experience and safety. Our Secondary Triage team is now the largest service of its type within an ambulance service in the world, connecting people who do not need an emergency ambulance with more appropriate care.
Our new Community and Consumer Engagement Plan (CCEP) 2023-2028 aims to strengthen our relationships through listening to understand lived experiences, and then working together to provide the right care at the right time to all Victorians.
We launched our new intranet, OneAV, providing a single hub for employees to access the tools, links and information they need to do their job and better connect with each other. We will soon provide paramedics iPads to complete patient care records and roll out new digital radio technology across regional Victoria.
Our dedicated paramedics and first responders are to be commended for the outstanding care they deliver across Victoria. We are immensely proud of all our people – frontline and corporate staff – for their dedication, passion and commitment to our community.
Hato Hone St John: Enhancing the Delivery of Emergency Services across Aotearoa
The 2023-2024 period has been a great year for Hato Hone St John, marked by innovation, growth, and a steadfast commitment to the communities we serve. Throughout the year, our focus has been on enhancing our services, supporting our workforce, and ensuring that we continue to deliver the highest standard of care across Aotearoa New Zealand.
One of the significant steps we took this year was launching our first electric vehicle (EV) ambulance. This initiative represents our initial foray into exploring the feasibility of EV technology within the demanding environment of emergency services. While it is early days, this trial is a crucial part of our commitment to investigating sustainable solutions for the future.
Alongside this, we have integrated advanced technology into our operations, including upgrades to our Computer Aided Dispatch (CAD) system, introducing a new rostering system and the introduction of a new ZOLL defibrillator platform, both of which have significantly improved the efficiency and effectiveness of our care delivery.
Workforce Development and Wellbeing:
We implemented strategies focused on improving key performance indicators such as 111 call answering times. This included targeted recruitment efforts, enhanced training, and refining processes to ensure that our teams are fully equipped and supported. As a result, we achieved significant reductions in call answering wait times, ensuring that the public receives faster access to emergency services.
In addition, we successfully implemented a remote triage system, which has played a crucial role in reducing the need for ambulance dispatch to low acuity patients. This system allows us to effectively utilise our remote workforce, providing timely and appropriate community-based care while using our limited ambulance resources efficiently.
The introduction of the Extended Care Paramedic (ECP) and Critical Care Paramedic (CCP) internship programmes has allowed our paramedics to enhance their skills and deliver more advanced care. Tactical commander training for our ambulance operations managers has further strengthened leadership and preparedness in emergency response scenarios. To support our teams, we also implemented a new rostering platform, optimising workforce management and ensuring our staff are well-positioned to meet the demands of their roles.
Service Delivery and Reliability:
Service delivery has also been a key focus area. To ensure the reliability of our emergency response, we expanded our fleet with the addition of 150 new ambulance vehicles. This investment is crucial in maintaining a dependable and ready fleet, capable of meeting the demands of our communities across the country. Furthermore, the introduction of an electronic medicines management platform has enhanced the safety and accuracy of medication administration in the field, further improving patient outcomes.
Community and Cultural Engagement:
Our commitment to community and cultural engagement has been unwavering. Through the Te Manawaroa (First Responders) programme, launched in Kaikohe and Te Tai Tokerau (Northland), we have deepened our relationships with Iwi Maori, integrating Maori perspectives into our emergency services. We have also continued our efforts to improve cultural competency within our teams, fostering an environment that is both inclusive and responsive to the diverse needs of our communities.
As we reflect on the past year, we are proud of the strides we have made to improve our services to better support both our people and our patients. Our achievements are a testament to the hard work and dedication of our teams, and as we look to the future, we remain committed to innovation, excellence, and the wellbeing of all New Zealanders.
NSW Ambulance
NSW Ambulance has undertaken several key initiatives to enhance its services and improve healthcare delivery.
Over the first two years of the multi-year SWIFT program, the Strategic Workforce Infrastructure Team (SWIFT) has strengthened the organisation by increasing rosters with adding an additional 637 paramedics across 51 stations and 123 Control Centre staff.
Our four Control Centres were recognised as Accredited Centres of Excellence (ACE) by the International Academies of Emergency Dispatch (IAED). The accolade puts our emergency medical call takers and dispatchers in the top four per cent of performers in the world.
In line with its commitment to inclusivity, NSW Ambulance launched the Aboriginal Health Action Plan 2024-2026 during National Reconciliation Week. This plan outlines strategies to improve access to services for Aboriginal and Torres Strait Islander communities, addressing long-standing disparities n healthcare delivery.
On 4 June 2024, NSW Ambulance introduced the NSW Ambulance Patient Charter, which establishes a shared understanding of the rights of individuals receiving healthcare. Developed with input from consumers, the Charter is intended to foster active partnerships between patients, families, carers, volunteers, and staff, promoting the provision of safe and highquality care. It aligns with the objectives of the NSW Future Health Plan and the Australian Charter of Healthcare Rights.
In December 2023, two custom built PC-24 jets were brought into our aeromedical fleet. The jets fly faster and further without the need for refuelling. The rollout of eight custombuilt hazardous area rescue ambulances (HARAs) commenced. To enhance its emergency response capabilities, NSW Ambulance has received eight new Inflatable Rescue Boats (IRBs) as part of the Flood Rescue Capabilities Program. These IRBs will improve on-water flood rescue efforts across the state, allowing Special Operations Team paramedics to deliver urgent healthcare in aquatic environments
NSW Ambulance also achieved success in the inaugural Australasian Water Rescue Challenge, with specialist paramedics from the Rescue and Special Operations, and Helicopter Operations Units winning the competition.
Finally, the GoodSAM program marked its six-month milestone in May 2024, highlighted by a reunion at Parliament House between cardiac arrest survivor Robert Salloum, the volunteers who saved his life, and the attending paramedics, underscoring the program’s life-saving impact. More than 7,000 volunteers have signed up to GoodSAM. The GoodSAM initiative saved 24 lives in 2023-24, and a statewide Automated External Defibrillator (AED) registry was established as part of this program.
Through the delivery of timely and patient-focused ambulance services, the
Queensland Ambulance Service
(QAS) forms an integral part of the primary healthcare sector in Queensland.
Operating as a statewide service within the Department of Health, the QAS is accountable for the delivery of pre-hospital ambulance response services, emergency and non-emergency pre-hospital patient care and transport services, interfacility ambulance transports, aeromedical retrieval and transfer services, casualty room services, confidential health assessment and information services, and the planning and coordination of multi-casualty incidents and disasters.
The QAS delivers ambulance services from 308 response locations through eight Regions and 17 Districts, with Districts being aligned to the state’s Hospital and Health Service boundaries. The QAS has eight operation centres located throughout Queensland that manage emergency call-taking, emergency operational deployment and dispatch and the coordination of non-urgent patient transport services.
The QAS also incorporates the Health Contact Centre (HCC) and Retrieval Services Queensland (RSQ). In addition, the QAS works in partnership with 135 active Local Ambulance Committees across the state, whose members volunteer their time to support their local ambulance service.
The following achievements are highlighted for the 2023-24 period:
• The ongoing development and expansion of the QAS Clinical Hub to operate 24/7, providing secondary triage and health care navigation for patients after they call Triple Zero (000).
• Introduction of the QAS Falls Co-Response Program in October 2023, designed for patients who have fallen with minor or no obvious injuries to ensure they are responded to and assessed sooner through using referrals to alternative treatment pathways to help patients stay in their own homes independently, for longer.
• Continued implementation of the QAS Leadership Capability Framework which outlines the skills and knowledge needed within leadership roles and development pathways to acquire skills.
• The completion of an Interfacility Transport (IFT) project pilot on the Sunshine Coast to ensure IFTs are managed efficiently to smooth demand and manage impact on acute crews. The project is now focusing on Cairns and Hinterland District.
• Launch of the QAS Digital Strategy 2024-29 ‘Building our Digital Future’ in May 2024 outlining the digital projects, products and initiatives required by the QAS into the future.
• Ongoing implementation of the QAS Workforce Plan, with a strong focus on organisational and individual Workforce Wellbeing.
• Continued implementation of the QAS Cardiac Arrest Plan within Regions to support better patient outcomes.
• The continued delivery of ambulance services during severe weather events between December 2023 and January 2024, including Tropical Cyclone Jasper impacting Far North Queensland, severe thunderstorms and multiple heatwave events in South East Queensland, and Tropical Cyclone Kirrily across Central and Northern Queensland.
• Continued implementation of culturally safe environments through the Indigenous Paramedic Program (IPP) initiative which is designed to enhance culture and belonging of Aboriginal and Torres Strait Islander peoples within the QAS workforce and Queensland communities.
• In June 2024, the QAS celebrated the recruitment of its 100th Indigenous Paramedic Program cadet since the Program’s commencement in 2012.
In 2023-24, SA Ambulance Service (SAAS)
released its Strategic Plan, outlining key operational goals it aims to achieve by 2027.
Embedded in the plan is the new RISE (respectful, inclusive, supportive, equitable) Culture and value set which will be the centre point of recruitment, leadership development, and drive for the service and its people.
SAAS has continued to remain on track for its Operational Growth Plan, with ground broken on the sites for new stations at Woodville, Edwardstown, Mount Barker and the Ambulance ‘Precinct’ in Mile End South, which will house the Adelaide Ambulance Station, new Emergency Operations Centre and the State Health Control Coordination Centre.
SAAS also welcomed over 67 extra paramedics, ambulance officers, clinical team leaders and emergency medical dispatchers as part of the Government of South Australia’s investment in the service’s future.
SAAS onboarded 98 paramedic interns, who have shown an immense maturity and professionalism, as they were prepared for life on the road in one of the toughest internship programs in the country.
SAAS is committed to growing the number of care pathways that clinicians can access for patients and works closely with Local Health Networks to be able to have direct access to services. This year SAAS redirected about 30% of its patients to other community services, keeping emergency departments for emergencies.
The third and final iteration of the volunteer recruitment campaign, Answer the Call, also successfully encouraged almost 200 members of the public to sign up to become a volunteer with SAAS. Most of SAAS’s regional stations are staffed by volunteers and SAAS works hard to acknowledge the selfless commitment of its volunteers through National Volunteer Week, volunteer conferences, public relations activities and awards presented at the SAAS Presentation Day.
Finally, one of the key goals of the Strategic Plan is to develop SAAS’s emergency management capability and contribute to the State’s emergency preparedness and response. This year SAAS delivered major incident training for ambulance responders and commanders. In 55 sessions, 755 staff were trained this year alone.
It has been an intense year of achievements lead by the service’s exceptional people.
St John NT continues to strive to deliver a high quality, contemporary, and efficient ambulance service that meets the needs of the Northern Territory community.
The passion of its people and their ability to adapt, overcome and problem solve in a unique and vast part of the country in often challenging circumstances, with limited resources, is directly reflected in their mission to save lives and build resilience to improve healthcare for all Territorians.
As a small service, St John NT is responding year on year to an increasing number of patients. The population that we serve is characterised by challenges due to access to health services and the tyranny of distance. This is reflected in the growth in acuity and case load reported in the latest research and reputational results. In 2023/24 financial year the national average of incidents per 1000 people was 161.7. The rate of incidents per population for 2023/24 financial year in the NT has risen to 248.9 per 1000 people. This year has seen an 11% increase in incidents responded to by ambulances and a corresponding 11.5% increase in Triple Zero (000) calls for ambulance
This increased workload demand was also compounded by attrition rates and rising recruitment costs due to the challenges of recruiting and retaining staff in remote locations. With revenue the lowest in the country, due to reduced funding, budget negotiations with the Northern Territory Government and NT Health towards renewing the Ambulance Services contract remained a dominant issue for the service in 2023/24.
Despite this St John NT recorded the highest overall patient satisfaction in the county at 99%. We were also encouraged by the ongoing daily positive feedback received from patients from across the Territory, with some regarding the care they receive in the NT as world class.
One such leader and role model of our service who daily gives far in excess of what is asked was Kylie Killalea, who was awarded a National Ambulance Service Medal 2024 as part of the Australia Day honours for her outstanding service to St John NT as a dedicated paramedic and operational leader.
St John NT continues to support major events showcasing the Northern Territory such as Bass in the Grass, The Garma Festival, V8 Suprecars, and the Tatts Finke Desert Race just to name a few. These events offer a unique opportunity for our paramedics and ICP’s to engage in clinically challenging and culturally diverse environments including remote locations to provide medical and retrieval support to ensure the safety of the community.
The team involved in the Toyota Commuter 4x4 Response Ambulance project forged an innovative solution to assist staff working in the rugged and vast environment characterised by the NT. The overall aim was to have the best of both worlds by developing a vehicle option with the space and treatment capacity of the Mercedes Sprinter and the off-road capability of a Land Cruiser. The new 4X4 model commuter is a giant leap forward for not only St John NT clinicians, but in the ability to deliver quality care in austere conditions to improve patient outcomes.
St John NT intern paramedics continue to flourish in the challenging but rewarding environments across the expanse of the Territory, with 10 graduates who have studied Paramedicine locally in the NT at both Flinders University and Charles Darwin University joining the ranks for the first time this year. This addition of ‘locals’ to the recruitment intern ranks will hopefully increase retention and a sustainable workforce into the future as subsequent classes finish their degree each year.
St John Papua New Guinea
The National St John Ambulance Council (NStJA) is an integral part of Papua New Guinea’s healthcare system, delivering emergency road ambulance services to areas of need and providing nationwide domestic air ambulance support.
In the 2023/24 fiscal year, NStJA enhanced its operations with a focus on efficiency, governance, and patient safety. These advancements are addressing the growing demand for ambulance services, driven by key health priorities such as snakebite, sepsis, trauma, and complex obstetric cases.
Operational Achievements
Incident Response: NStJA responded to 35,676 emergency incidents, marking a 43% increase from the previous year and demonstrating the community’s growing reliance on the ambulance service.
The road ambulance network now serves approximately 2 million people, representing about 20% of PNG’s population.
Specialised Operations: Our people played a pivotal role in supporting state visits from presidents and prime ministers, managing responses to civil unrest, and collaborating with our defence force, state agencies and overseas military forces to plan for and respond to major incidents.
Technological Innovation: We transitioned to a new push-to-talk over mobile data system, appreciably improving our coverage and at the same time reducing communication costs. We continue to use HF, VHF and satellite systems as a failsafe.
Workforce and Training
Our team of 341 St John People continued to provide exceptional care and support to Papua New Guineans throughout the year. We formed a new ambulance education unit and implemented a modernised clinical governance framework to enhance patient safety. Additionally, we introduced advanced training courses for our doctors, nurses, and paramedics.
Snakebite Program
Through a partnership with the Australian Government and CSL Seqirus, NStJA is leading the delivery of specialised snakebite training to healthcare professionals and distributing snakebite antivenom to high-risk areas. This initiative, along with our critical care snakebite retrieval capability, has been instrumental in addressing one of PNG’s major health challenges.
Advanced Driver Training for Emergency Responders
NStJA introduced an internationally accredited Advanced Safe Driver Training program for ambulance personnel. Our accredited trainers will deliver this program to staff across the country and incorporate it as part of recruit basic training.
Service Expansion
We commenced planning for new ambulance stations in the Eastern Highlands and Gulf Provinces and were pleased to bringonline new stations in the Central Province towns of Kuriva and Kupiano.
Now in its second year, our people continued supporting the Australian Federal Police as part of the PNG-Australia Policing Partnership Program. In 2024, we expanded the paramedic support program to Lae and Kokopo alongside the AFP. We’re expanding the program to Mt Hagen in August 2024.
Community Engagement
Our community-focused initiatives, including First Aid in Schools and enterprise first aid training programs, equipped over 9,388 people across Papua New Guinea with vital first aid skills, strengthening the nation’s capacity for community-based emergency care.
Looking Forward
NStJA remains steadfast in its commitment to serving the Papua New Guineas and striving for excellence through innovation, technology, and a focus on continuous improvement. We aim to set the benchmark for ambulance systems in PNG and the Pacific, and this starts with nurturing a proficient and resilient ambulance workforce. These efforts underline our mission to be an agile, trusted and inimitable pillar of PNG’s healthcare system.
Record performance, awards and transformative uplift at St John WA
St John WA’s forward-thinking evolution and collaboration with key stakeholders continued to pay dividends in supporting more than 217,000 patients avoid ambulance transport to an emergency department (ED) for the year. Health WA’s Virtual Emergency Department (WAVED) was established with SJWA’s Secondary Triage Team (STT) at its clinical hub in ongoing efforts to address ramping.
A record 32.3% of patients accessed care away from emergency ambulance and more than 127,000 patients attended one of SJWA’s six premium Urgent Care centres rather than attending a public ED.
With such focus on patient pathways the customer satisfaction rating for SJWA ambulance improved to 98% overall – above the national average. This was supported by an average of 97.4% of Triple Zero (000) calls being answered within 10 seconds over the year, and in April the State Operations Centre team celebrated their first 100% day – followed by plenty more.
On road performance had year-on-year improvement in Priority 1, 2 and 3 average response performance.
Investment in uplifting infrastructure and technology to set SJWA up for the future has begun, with more than 90 projects and digital transformation program underway across WA.
Thanks to Paramedic Lauren D’Arcy’s trailblazing efforts, SJWA became the first emergency service in Australia to provide Auslan interpreting services for the Deaf and hard of hearing community. A new Auslan translation app by Convo Australia was rolled out to St John health services and ambulance iPads, which have priority access to on-demand sign language interpreting through the app’s video call.
SJWA’s revolutionary State Obstetrics Referral Call (STORC) led up by Paramedic and Midwife Mel Gardiner celebrated one year, 100 calls and more than 22 births, with positive outcomes for all on scene.
SJWA’s strengthened service in becoming the first ambulance jurisdiction to deliver Take Home Naloxone enjoyed peer recognition for Excellence in Clinical Practice at the 2023 CAA Awards, as well as the clinical upskilling of Critical Care Paramedics, whose cohort was extended to on road to help stabilise critical cases in Perth’s urban fringe, also being recognised for Excellence in Staff Development.
Sadly, the team mourned the loss of Clinical Support Paramedic Tinesh Tamilkodi while responding to a P1 job and Paramedic Fiona Lavelle, who was on a remote hiking holiday. In their memory a scholarship has been set up to support more First Nations healthcare students and development of future leaders at SJWA.
Wellington Free Ambulance
Wellington Free Ambulance (WFA) is the emergency ambulance service supporting the community across Greater Wellington & Wairarapa in Aotearoa New Zealand.
2023-2024 Highlights
Build Wairarapa Station
2023 saw the launch of an ambitious property and fundraising project in the Wairarapa region. Wellington Free Ambulance announced a $8.5 million infrastructure project to build a dedicated IL4 rated ambulance station to strengthen their resilience in the event of a civil emergency and to continue to serve the community for decades to come. Funding for this build is a shared approach between Wellington Free, Government and the community. The community response was unanimously supportive with local Council, grant makers, businesses and individuals offering support. A $1million gift early on from a local family created a buzz of excitement and motivated giving across the region. A second $1million gift from a high-profile iconic NZ couple – Sir Peter Jackson and Dame Fran Walsh –pushed the fundraising closer to the total needed. The physical build is well underway, the fundraising campaign for both the build and fit out is in the final phase with the team anticipating a move in date of April 2025.
The Lloyd Morrison Foundation Heartbeat Training Programme
The Lloyd Morrison Foundation Heartbeat Community CPR Training Programme, now in its 10th year, trained over 7000 people in vital lifesaving CPR skills and how to use an AED. 209 courses took place across the region, completely free of charge thanks to the ongoing support of Julie Nevett and The Lloyd Morrison Foundation. As well as training people how to provide immediate assistance with CPR in the event of a sudden cardiac arrest, WFA is one of the largest suppliers of AEDs in the region through the Heartbeat Programme. Last year, 105 new AEDs were installed, taking the total installed during the Programme’s lifetime to 520. During the year WFA expanded the Heartbeat tutor team to meet the increased demand for CPR training and now includes paramedic students and three Pasifika tutors who provide culturally appropriate training to the Pasifika community.
Record onboarding and recruitment round
Over the past 12 months Wellington Free Ambulance has welcomed record numbers of new recruits to the frontline services team. 27 new graduates who have recently completed the Diploma of Paramedicine, 22 experienced paramedics many of whom who have relocated from overseas to join Wellington Free and 33 new members of the Clinical Communications Centre team have been onboarded and are now supporting the community across the region in a range of roles.
CAA Awards Win
The team from Wellington Free Ambulance who attended the Conference in 2023 were blown away to come home with several trophies and acknowledgements from the Awards. Wellington Free Ambulance submitted and were finalists in three categories, with the international judging panel awarding:
• Excellence in Patient Care – The Case for Prehospital Telestroke.
• Excellence in Mental Health and Wellbeing – The Review of Shift Pattern and Fatigue at Wellington Free Ambulance.
• Star Award – The Review of Shift Pattern and Fatigue at Wellington Free Ambulance.
WFA was thrilled to be recognised with The Star Award for the most innovative and groundbreaking initiative across all categories. The Shift Pattern project that Wellington Free Ambulance was recognised for looks at the impact and implications of shift work, not only for staff, but also for families, patients, and the wider community. The purpose of the work was to explore options that reduce the burden of fatigue long term. During the year this Shift Pattern work has transitioned to implementation.
The CAA plays a vital role in coordinating and advocating for the ambulance health sector.
It is committed to continuous improvement through education and professional development programs, facilitating communication and collaboration among different ambulance services.
Behind the scenes, CAA committees, groups, and forums play a significant role in shaping the policies, protocols, and standards that govern the ambulance health sector. During 2023-2024, the groups, committees, and forums continued to coordinate efforts among CAA members towards advancing the ambulance sector’s interests, promoting best practices, and addressing key challenges facing the ambulance health sector.
Group Structure
CAA Board
The Research and Policy Department of the Council of Ambulance Authorities (CAA) has consistently demonstrated its dedication to the advancement and support of the ambulance sector. This commitment is manifested through a multifaceted approach that encompasses the promotion of quality care, the pursuit of excellence in emergency management, the development of comprehensive educational programs, and the facilitation of professional development initiatives.
Committees, Forums and Groups
Collaborative Efforts
The CAA’s various Committees, Working Groups, and Forums serve as the cornerstone of the organisation’s efforts to shape and refine the policies, standards, and protocols that govern the ambulance sector’s operations.
These collaborative bodies have made significant strides in the 2023-2024 period, spearheading crucial initiatives to address the complex challenges facing ambulance services.
Key Achievements
Professional Development
The CAA has successfully implemented a range of programs aimed at enhancing the professional development of the ambulance leaders. These initiatives have been instrumental in ensuring the continued evolution and prosperity of the ambulance sector.
Knowledge Exchange
A primary focus of the CAA has been the creation of platforms that facilitate communication and knowledge exchange among ambulance services. This approach has fostered a collaborative environment conducive to sharing best practices and innovative solutions.
Policy Formulation
Through rigorous research and extensive consultation with stakeholders, the CAA has played a pivotal role in formulating evidencebased policies that address the sector’s most pressing issues.
Impact on the Ambulance Sector
The collective efforts of the CAA’s Committees, Working Groups, and Forums have resulted in:
1. Enhanced operational efficiency across ambulance services
2. Improved patient outcomes through the implementation of best practices
3. Strengthened resilience of the sector in the face of emerging challenges
The Research and Policy Department of he CAA continues to be a driving force in the ambulance sector, consistently delivering value through its strategic initiatives and collaborative approach
Aeromedical Forum (AF)
40,193+ flying hours
In 2022-23, Australian and Papua New Guinea ambulance services spent over 40,193 hours flying using fixed and rotary wing aircraft.
The Aeromedical Forum of the CAA serves as a platform to promote collaboration among ambulance services in delivering aeromedical care across Australia, New Zealand, and Papua New Guinea.
Recent AF meetings have brought together a diverse array of first responders, clinicians, administrators, and representatives, providing a unique platform for collaboration, networking, and sharing expertise. These meetings have facilitated discussions on important topics such as ongoing revisions to national aeromedical and air search and rescue protocols.
86 fixed and rotary aircraftwing
Including 71 Australian based aircraft, and 15 aircraft based in Papua New Guinea.
A key focus of the Forum has been the development of a position paper on flexible working arrangements for helicopter paramedics. Members have emphasised the importance of education, the need to adapt organisational practices to societal changes, the formulation of a policy directive for these arrangements, and the importance of member involvement in decision-making for successful implementation.
www.caa.net.au/caa-groups
Members have highlighted that aircraft interiors can reach significantly higher temperatures than the external environment, an issue exacerbated by air conditioning failures. Proposed solutions include allowing discretionary offline status for aircraft experiencing air conditioning issues, implementing mandatory physiological monitoring for missions in high temperatures, and reviewing wetsuit options to improve heat mitigation.
The Forum has also addressed the challenges of transporting radiologically contaminated patients, focusing on the need for established transportation protocols and identifying appropriate hospitals for such patients. Members have expressed a desire to share knowledge, guidelines, and suggestions both among themselves and with external organisational partners to enhance protocols.
The AF continues to contribute to the improvement of aeromedical care and operations, advocating for safety, standardisation, and collaboration across the sector.
The Ambulance Education Committee (AEC) of the CAA continued to oversee educational elements for the working staff of member services and future paramedics across Australasia during the 2023-2024 period.
Regular meetings of the AEC have focused on reviewing updates in various areas, including CAADA and training simulations, curriculum advancements, student enrolment data, and university statistics. The Committee has also overseen ongoing paramedicine-related surveys, fostering a collaborative environment that encourages members to contribute additional insights and data.
The strengthened collaboration with the AHPRA Committee was one of last year’s achievements for the AEC. This partnership has facilitated ongoing feedback and refinement of accreditation and educational standards.
The inclusion of key representatives from the Paramedicine Accreditation Committee of AHPRA in group discussions has marked a step forward in this collaborative effort. The AEC intends to build upon this partnership in the coming year, ensuring that the evolving needs of the paramedicine sector are met through robust and adaptive accreditation processes.
Recognising the importance of leadership development within the ambulance sector, the CAA has initiated a comprehensive review of leadership programs offered member services. This strategic initiative aims to inform the development of new, tailored leadership programs designed to enhance the skills and potential of paramedics, ultimately strengthening the leadership pipeline within the sector. The AEC has engaged in discussions on specialty practice registration for community and critical care paramedics.
During its 2023-2024 meetings, the Committee addressed several topics impacting paramedic education, including deteriorating patient assessments, the application of early warning scores, sepsis guidelines, and psychosocial safety considerations. Additional subjects of focus included national banking and quality health service standards, challenges faced new staff, social media and professionalism, and palliative care initiatives.
The Committee’s most recent gathering concluded with an Enhanced Capability Tour in New South Wales Ambulance. Members had the opportunity to visit the Hazardous Area Rescue Ambulance (HARA) and flood rescue resources. This hands-on experience, facilitated a special operations paramedic, provided valuable insights into the operational capabilities and challenges faced emergency services in threatening situations.
Total Student Enrolments by Year
2022-23
The Clinical and Patient Safety Committee (CPSC) of the CAA continued to provide a platform for Medical Directors and Clinical Managers to discuss clinical issues affecting the quality of ambulance services.
The members aimed to ensure that strong patient safety measures and effective quality improvement systems are in place.
During the 2023-24 period, the CPSC has been dedicated to developing national standards for clinical practice guidelines. The group has started working on the Sepsis guideline, which is currently under review to build consensus among our members. Over the past year, members have had in-depth discussions and proposed several reliable, evidence-based solutions to help paramedics recognise patient deterioration in a timely manner.
The CPSC emphasised the importance of drug preparation standards and checking procedures. To support this initiative, the CAA is establishing a new Networking Group for Pharmacists, aiming to strengthen future collaborations and ensure best practice implementation.
Improving patient record access remains a priority for the CPSC, with encouragement for services to share experiences regarding the retrieval of previous ambulance patient care records during subsequent attendances. Other key discussion topics included improving data collection on complications arising from mechanical compression devices and the strategic deployment of ECMO to optimise resource allocation and enhance patient outcomes.
Forum (DIB)
The year 2023-24 is regarded as the establishment year for the Diversity, Inclusion & Belonging Forum (DIB) of the CAA, highlighted by its inaugural in-person meeting in Sydney.
This group has begun to play an important role in addressing the challenges faced by diverse groups within the ambulance sector. The Forum’s efforts align with broader industry trends aimed at creating more inclusive workplaces that reflect the diversity of the communities they serve.
The Forum has covered a range of topics that highlight the various aspects of diversity in both the community and the workplace. One important topic discussed was providing safe and quality care for First Nations communities. This included conversations around the Aboriginal and Torres Strait Islander Cultural Safety Policy, efforts to achieve health equity for Māori, and the importance of asking patients if they identify as Aboriginal and/or Torres Strait Islander, ensuring their responses are accurately recorded. These ongoing projects, along with similar initiatives, focus on ensuring the highest standards of care for First Nations communities
Sexual safety in the workplace and efforts to reduce sexual harassment in line with national regulations were another important topic. The Forum engaged in deep discussions with a professional expert in the field. The Forum is working towards the publication of CAA’s Sexual Safety in Ambulance Healthcare Services position statement. This document outlines a detailed background and provides 10 actionable steps to create a framework for eliminating sexual harassment within the sector.
The Forum’s discussions on neurodiversity inclusion indicate a growing awareness of the importance of accommodating diverse cognitive styles in the workplace. This aligns with emerging trends in workplace diversity and inclusion, recognising that neurodiversity can bring valuable perspectives and skills to organisations.
The DIB Forum’s initiatives reflect a holistic approach to diversity and inclusion, addressing various aspects including gender equity, cultural safety, sexual harassment prevention, and neurodiversity. These efforts are necessary in creating a more inclusive and representative ambulance sector, leading to improved service delivery and better health outcomes for diverse communities.
Emergency Management Committee (EMC)
The Emergency Management Committee (EMC) of the CAA continued to
facilitate information exchange and providing strategic guidance on emergency management
across member ambulance services.
The committee’s scope encompasses important areas such as resource capacity impact assessment, national standards development, and technical advisory services. To ensure comprehensive awareness of the national emergency landscape, the EMC regularly receives updates from member services and briefings from key organisations like the National Emergency Management Agency (NEMA) and The Health Sector Group (TISN).
During the 2023-24 period, the EMC concentrated its efforts on two major initiatives. The first involved developing a national leadership training program for commanders, aimed at standardising and enhancing leadership capabilities across ambulance services. The second focused on establishing a unified approach to Chemical, Biological, Radiological, and Explosive (CBRE) practices and training. This latter involved extensive collaboration, drawing upon resources from member services and international partners to create cohesive standards.
Sharing and analysing significant state events is a permanent discussion item in EMC meetings. These discussions provide invaluable insights into real-world emergency management challenges, covering strengths, weaknesses, lessons learned, and post-trauma interventions. In the past year, the committee conducted in-depth analyses of several high-profile incidents, including the NSWA Bondi Junction event, the LATAM Airlines incident, and New Zealand’s CrowdStrike ICT outage. Each case study offered unique perspectives on crisis management strategies and outcomes. This year, the committee also discussed the review of mass casualty management and evacuation protocols. This process began with an examination of mass casualty equipment, which laid the groundwork for more comprehensive planning and preparedness.
The EMC’s most recent meeting concluded with an Enhanced Capability Tour in New South Wales Ambulance. Committee members visited the Hazardous Area Rescue Ambulance (HARA) facilities and flood rescue resources, gaining firsthand knowledge of operational capabilities and challenges in managing hazardous situations. This practical experience, guided a special operations paramedic, provided committee members with a deeper understanding of the complexities faced emergency services in the field.
Fleet and Equipment Forum (FEF)
Total Australian Road Fleet 2022-23
154,374,459 km travelled
In 2023-2024, the CAA’s Fleet and Equipment Forum (FEF) continued to oversee the safety, reliability, and suitability of ambulance fleets and equipment, maintenance protocols, procurement strategies, and operational readiness through ongoing discussions and insightful presentations from leading international companies.
A highlight of the forum’s activities is the annual in-person Fleet meeting, which includes a study tour for members. This event offers valuable opportunities for participants to visit facilities, witness demonstrations, and explore new technologies in medical equipment and rescue vehicles. During these meetings, ambulance services engage in meaningful discussions, exchanging ideas and sharing best practices that enhance their operations.
In recent discussions, the FEF has focused on several topics. One significant area of exploration has been the design of bariatric vehicles. The Forum has addressed the challenges associated with creating vehicles that accommodate bariatric patients while considering the unique requirements of each service.
Furthermore, members have shared insights on the secure transport of paediatric patients, emphasising the importance of safety during these critical situations. The safe use of Extracorporeal Membrane Oxygenation (ECMO) devices has also been a prominent topic of discussion, with members sharing real-life experiences to enhance understanding and improve practices.
The FEF emphasises a collaborative approach to fleet and equipment management. This strategy allows for the integration of specific needs from each service into vehicle design and equipment selection, ensuring that solutions are tailored to meet diverse operational requirements.
Alliance (GRA)
Networking Group
The Global Resuscitation Alliance (GRA) Networking Group continued its discussions aimed at enhancing cardiac arrest survival rates.
The 2023-24 discussion topics included GRA Masterclasses, specialised training in High-Performance CPR for paramedics and call takers, and campaigns promoting mandatory CPR education in schools, along with the development of Automated External Defibrillator (AED) registries.
Group members highlighted the details of adapting the GRA’s 10-step program to improve in-hospital cardiac arrest outcomes by leveraging insights gained from Out-of-Hospital Cardiac Arrest (OHCA) cases. Advocating for mandatory CPR training in schools is an important ongoing initiative of this Networking Group. The CAA published a paper which seeks to incorporate CPR education into school curricula or as a requirement for driver’s license testing.
The rationale for this initiative is compelling; bystander CPR has been shown to significantly improve survival rates in cardiac arrest cases. Standardised and mandatory training would ensure that more individuals are prepared to act effectively in emergencies. While many schools currently offer CPR training, it is often optional and varies in quality. Making this training compulsory would guarantee that all students receive comprehensive and effective education in CPR.
Another important discussion involved legislation surrounding AEDs. Members exchanged updates regarding AED laws within their respective jurisdictions and shared strategies employed by their affiliated services to enhance public access to and awareness of AEDs. Additionally, members provided insights into ongoing trials aimed at increasing survival rates following cardiac arrest. One promising area of research focuses on pre-hospital Extracorporeal Cardiopulmonary Resuscitation (ECPR) for patients experiencing refractory cardiac arrest. The outcomes of these trials are anticipated to yield valuable insights that could benefit both the healthcare sector and the broader community in the years to come.
and Prevention Management Networking Group
(ICPMNG)
The Infection Control and Prevention Management
Networking
Group (ICPMNG) has continued to meet regularly, focusing on improving infection control in the ambulance sector and addressing the ongoing risk of pathogen exposure for emergency service personnel.
This collaborative platform enables ambulance authorities to exchange best practices, knowledge, and experiences related to infection control.
In 2023-2024, the ICPMNG focused on several key initiatives to improve infection prevention strategies. A significant topic of discussion was the update of Infection Prevention and Control (IPC) kits. Members engaged in comparisons of current kit components across jurisdictions, sharing insights from recent trials and real-world experiences to determine the most effective approaches for enhancement. Sustainability emerged as a new priority for many services, with a specific focus on infection control.
The group explored best practices in sustainable procurement, waste management, and infection control techniques that support environmentally friendly operations. This aligns with the global trend towards more sustainable healthcare practices, as outlined in the World Health Organisation’s Global Action Plan on Antimicrobial Resistance.
The implementation and assessment of aseptic techniques in prehospital settings presented a notable challenge. Members acknowledged that even hospital environments struggle with slow and difficult competency assessments and audits in this area. Consequently, the group reached a consensus that enhanced training would be the most effective intervention to improve aseptic technique practices in the field.
Mental Health and Wellbeing Forum (MHWF)
The Mental Health and Wellbeing Forum (MHWF) of the CAA continued its activities addressing the mental health needs of ambulance personnel across Australia, New Zealand, and Papua New Guinea.
Recognising the unique challenges faced by ambulance staff, including exposure to trauma, demanding work schedules, and high-stress environments, the MHWF has taken an approach to promoting mental health awareness, advocating for resources, and providing essential support.
In 2023, the MHWF updated the CAA mental health and wellbeing position statement, replacing it with the new Psychological Safety and Wellbeing Position Statement. This position statement provides guidance for ensuring the psychological and psychosocial safety of both employed and volunteer staff throughout their careers in emergency medical services. The statement outlines initiatives to enhance workplace psychological safety, mitigate psychosocial hazards, and cultivate protective factors that build resilience across the workforce.
The Forum’s activities in 2023-2024 focused on developing evidence-based resources and implementing strategies to address mental health challenges within the ambulance sector. Regular meetings facilitated discussions on innovative approaches to promote mental wellbeing among personnel. The MHWF hosted a series of presentations, including sessions on “Feel Brave Books,” the “Responders Digital Hub,” and the “Mental Health Screening project for first responders.”
Collaboration with academic institutions, peer first responder organisations, and research bodies remained a priority for the MHWF. These partnerships resulted in valuable studies examining the mental health challenges specific to ambulance personnel. The research findings contribute to the development of best practices and innovative approaches tailored to the unique needs of the ambulance sector.
The 10 steps of psychological safety and wellbeing in the ambulance sector.
1 2 3 4 5 6 7 8 9 10
Strategy
Implement a psychological/psychosocial safety strategy to promote a positive wellbeing culture in the workplace through leadership, management commitment and accountability, communication, policy and procedure, environment, and workplace flexibility ( e.g., Psychosocial Safety Climate (PSC) 12 model).
Education
Acknowledge, accept, and normalise psychological conditions in the workplace and enable staff to have access to the resources that may improve their psychological/psychosocial safety and wellbeing literacy.
Share Responsibility
Develop a shared responsibility across the organisation to proactively, and holistically, support someone experiencing personal challenges or psychological hazard which may be impact on their psychological/psychosocial safety.
Integration
Ensure that an integrated approach to psychological/psychosocial safety and wellbeing is woven through the workplace and that leadership at all levels model behaviours and practices that promote a healthy workplace culture.
Share
Share examples of psychological/psychosocial safety initiatives based on evidence informed best-practice between services through CAA forums and sector collaboration opportunities.
Expertise
Engage a range of specialist expertise to achieve a holistic approach to improved psychological/psychosocial safety and wellbeing outcomes for the workforce.
Support
Ensure staff, during their career life cycle have adequate self-awareness, knowledge, resources, and support in relation to managing their wellbeing journey and responding to psychological hazards.
Wellbeing Systems
Implement systems that help keep people psychologically well, with a focus on prevention and early detection of organisational, environmental, climate, and other external psychological hazards.
Accountability
Be accountable by collecting, monitoring, and responding to data that evaluates the psychological/psychosocial safety and wellbeing of the workforce, highlights the psychological/ psychosocial hazards, and prevents the possibility of psychological injury occurring.
Cultivation
Cultivate an emotionally safe and resilient workforce by supporting the workforce to be aware of cultural sensitivities and by acknowledging, the value of the rich diversity and cultural preferences that underpin and identify the workforce.
The Occupational Violence Networking Group (OVNG) of the CAA has addressed the growing concern of workplace violence against ambulance personnel
This collaborative body, comprising representatives from CAA member ambulance services, focuses on developing and implementing strategies to prevent and manage occupational violence, thereby ensuring the safety and wellbeing of frontline staff. A primary objective of the OVNG has been looking at policies and procedures for managing occupational violence.
In the past year, the OVNG continued to report data on occupational violence across services. This initiative aims to provide a reliable benchmarking reference, enabling ambulance services to identify trends and areas for improvement. The group continues to refine definitions and methodologies to enhance the reliability and validity of the benchmarking report. The report helps to inform the creation of targeted strategies for more effective prevention and management of violent incidents.
Refining occupational violence (OV) training remained a significant focus of the group’s discussions. Members exchanged insights on effective OV training models and methods for evaluating training outcomes. Several services presented innovative training approaches with promising results, garnering interest from other members. This ongoing exchange of best practices facilitates the continuous improvement of training programs, better equipping staff to handle potentially violent situations.
The OVNG addressed emerging topics in 20232024, including risk management procedures for sexual assault against ambulance staff, policies for dealing with persons of interest, service withdrawal protocols, and on-scene police support. Members shared experiences and provided valuable resources to assist other services in strengthening their policies and procedures in these critical areas.
Research promotion has been another key focus of the OVNG, particularly regarding the incidence and impacts of occupational violence in ambulance services. Throughout the year, members discussed ongoing research in various jurisdictions, with a particular emphasis on staff protection initiatives such as body-worn cameras and stab-resistant vests. While these measures are gaining traction, the group continues to explore their strengths, weaknesses, and practical implications through rigorous research and data sharing.
The Operations Committee (OP) of the CAA oversees and optimises the operational functions of ambulance services across Australia, New Zealand, and Papua New Guinea.
Comprising seasoned professionals from CAA member ambulance services, the Committee is committed to driving continuous improvement and operational excellence in the sector.
The Committee discussions focused on managing shift timings, overtime, and paramedic fatigue. Members shared ongoing projects within their affiliated services, such as new rosters and shift patterns designed to reduce overall fatigue. Key elements of these initiatives include smart rostering and monitoring checks. They also discussed the real-world challenges of implementing these changes at the management level and gained valuable insights from other services.
The Committee facilitated engaging discussions on contemporary operational trends. Police support at the scene was a key topic for all member services, with discussions exploring various perspectives and potential actions to address the issue.
The Committee also hosted external organisations for presentations, where new technological tools to support rostering were introduced. A demonstration of the self-erecting emergency inflatable tent was featured during this year’s in-person meeting. Throughout these presentations, group members explored potential collaborations and innovative approaches to improving ambulance services.
The collaborative ethos of the Operations Committee has been evident throughout the year, with regular meetings fostering cooperation and coordination among ambulance services. These gatherings have provided valuable platforms for the exchange of best practices, lessons learned, and information that benefit all participating services.
Ambulance Services Response Times
(QSAF)
97%
The
Quality Standards and Accreditation Forum (QSAF) of the CAA continued to facilitate communication among Australasian ambulance services
with a shared goal of delivering high-quality care.
Members provided updates on their services’ accreditation progress, achievements, ongoing challenges, and initiatives to meet quality standards, sharing their firsthand experiences.
Some members are in the process of planning or implementing new accreditation procedures, and they shared relevant materials and proposals with the group. Discussions also focused on early warning scores and adult deterioration detection systems, with the aim of exchanging insights to establish a reliable standard for service delivery.
The national adverse events policy, updates on New Zealand’s patient experience survey, and open disclosure frameworks are key topics members were eager to focus on. They sought details and shared updates from their respective services on any related actions. Members also exchanged relevant documents from their services to support and assist peers in other jurisdictions.
Updates on the NHQHS Workbook and Paramedical Care Clinical Indicators were regular topics of discussion in last year’s forum meetings. These updates aim to keep members informed about the progress of KPIs, accreditation resources, and updated criteria for quality care.
Overall Patient Satisfaction with Ambulance Services by Year
New Zealand overall satisfaction
The Strategic Business Committee (SBC)
of the CAA has been actively engaged in discussions regarding strategic direction, business development, resourcing, planning, and reporting for ambulance services across Australia, New Zealand, and Papua New Guinea.
The committee’s efforts were instrumental in establishing strategic priorities and goals that enhanced the delivery of high-quality ambulance care across the region. Regular meetings addressed important matters such as financial management, governance, policy development, and the alignment of strategic initiatives with the CAA’s overarching strategy.
A notable development during this period was the formation of a new working group tasked with reviewing ambulance Key Performance Indicators (KPIs) and frameworks. This initiative aimed to create an updated list of indicators that accurately reflects the current efforts of ambulance services across all aspects of care in national and jurisdictional reports.
Members engaged in discussions about potential strategies to enhance the patient experience survey, drawing on the diverse experiences of all member services.
Other important discussion topics included AED registries, the management of lost hours, occupational violence, and flexible work arrangements. Members of SBC have been kept informed about the latest CAA reports and the results of internal data collections. SBC also hosted external presenters who addressed key sector topics, including organisational sexual safety and related legislation.
Recognising the importance of a skilled and diverse workforce, the SBC focused on identifying workforce trends, addressing skill gaps, and promoting diversity, equity, and inclusion within the ambulance sector. The committee shared strategies to attract and retain talent, including discussions on flexible work arrangements for paramedics and ambulance staff. Sustainability emerged as a central theme in the SBC’s strategic plans and discussions throughout the year, reflecting the growing importance of environmental considerations in healthcare delivery.
Ambulance Workforce by age group, by jurisdiction 2022-23
Networking Group (ASNG)
Following the adoption of CAA’s sustainability strategy in 2020 and the release of a benchmarking report outlining key sustainability KPIs in 2021, the CAA Board established the Ambulance
Sustainability Networking Group (ASNG)
this year.
The ASNG aims to create a platform for services to share insights, discuss challenges, and advance the sustainability of Australasian ambulance services.
ASNG’s primary objective was to cultivate a positive sustainability culture while minimising the environmental impact of ambulance service delivery. The group’s efforts were instrumental in strengthening collective action towards environmentally responsible solutions.
A significant milestone was the publication of the Ambulance Sustainability White Paper on the CAA website. This comprehensive document serves as a practical resource for ambulance services, addressing real-world challenges faced by various jurisdictions. It offers actionable strategies for improvement and includes vendor information for critical areas such as waste management. Designed as a living document, the white paper will evolve with technological advancements, continually driving sustainability in the sector.
Throughout the year, the group shared work on operational innovations, community-driven projects, and environmental initiatives, fostering a sustainability-first mindset among members. The group also engaged in valuable exchanges on uniform recycling practices and explored costeffective solutions and funding opportunities for sustainable practices. This collaborative approach ensured that all member authorities remained well-informed about the latest sustainability challenges and trends, enabling them to identify opportunities for unified approaches to shared issues.
As the ambulance sector continues to evolve, ASNG’s work remains crucial in promoting and implementing sustainable practices across Australia, New Zealand, and Papua New Guinea. Their ongoing efforts contribute significantly to the broader goal of creating more environmentally responsible and efficient ambulance services in the region.
The CAA recognises the importance of enhancing gender diversity, especially in leadership positions within the ambulance industry.
At the forefront of these efforts stands the Women in Ambulance Forum (WIAF), collaborative platform uniting female leaders from ambulance services across Australia and New Zealand. This Forum addresses the unique challenges faced women in the ambulance services, providing a supportive network that nurtures career development, mentorship, and advocacy for increased gender diversity and inclusion.
WIAF plays a pivotal role in highlighting the value of gender diversity in leadership and its positive impact on the ambulance sector. Through shared experiences and open discussions, the Forum illuminates specific barriers faced women in leadership positions, fostering an environment of mutual support and learning. Members exchange ideas and strategies to navigate and overcome obstacles, creating a robust support system. In the past year, WIAF has maintained its mission hosting regular meetings, workshops, and events focused on addressing these challenges and celebrating recent achievements women in the ambulance sector.
In line with its objectives, WIAF has been instrumental in spearheading several key CAA initiatives. These include the annual Women in Ambulance (WIA) Awards, the WIA Scholarship, the Women in Leadership Symposium, and the newly introduced WIA Development Program. Forum members have been actively involved in organising these events, promoting them across the sector, and assisting in candidate selection processes.
WIAF remains committed to mentoring future leaders, with a particular focus on candidates in the WIA Development Program, ensuring the next generation of female leaders is wellprepared to assume greater roles within the ambulance sector.
In November 2023 the CAA held a stand-alone Women in Leadership Symposium full of insightful presentations featuring women leaders and guest speakers from both national and international ambulance sectors. The Symposium served as a source of inspiration for current and aspiring ambulance leaders, offering valuable guidance on leadership growth and career advancement.
WIAF continues to advocate for equal opportunities, working closely with policymakers and stakeholders to develop policies that address gender disparities. The Forum actively promotes the importance of gender diversity in the workplace, striving to foster a more inclusive future for the ambulance industry.
The CAA’s Marketing, Communications and Events team are responsible for all outgoing information regarding upcoming campaigns, events as well as relevant news.
Along with distributing information, the CAA Marketing team are responsible for the management, creation and editing of all social media and digital content that comes under the CAA brand. The CAA Marketing and Communications team also manage the CAA social media & digital platforms.
After last years results, the past year has been a focus on continuing to grow the CAA audience on its respective social media platforms. This has been achieved through the continued distribution of popular content as well as creation of new content through engaging campaigns.
With a variety of campaigns driven by the CAA team throughout 2023-24, the CAA has seen growth in audiences across the nation and globally. Aside from continuing the publication of internationally renowned first magazine, the CAA MARCOMMS team organised an activation for Restart a Heart Day, continued publishing online webinars, as well as upkept an informative website all while delivering important and relevant content from the ambulance sector on CAA’s online channels.
During this period, the CAA has persistently pursued its objectives to fulfill the information, connectivity, and educational needs of the Australasian ambulance sector and beyond.
For some, it is meeting their inter-service colleagues for the first time and for others, CAA Congress is a reunion opportunity for members of the Ambulance sector from across Australasia.
During August of 2023, CAA members travelled to sunny Queensland for CAA Congress and the coveted Awards for Excellence.
Held at the Brisbane Exhibition and Convention Centre, conference attendees were part of a variety of networking events as well as several learning opportunities through plenary sessions and mini masterclasses.
Before commencing the CAA Congress, Adam Harper, MP, Member for Thuringowa, warmly welcomed attendees to Queensland, expressing his enthusiasm for hosting such a significant event. He emphasised the importance of collaboration and innovation in addressing community challenges, encouraging participants to engage actively in the discussions ahead.
Over two full days, attendees had the opportunity to join a variety of sessions with topics ranging from personalising of healthcare to AI inclusion in Paramedicine. Alongside these plenary sessions, attendees were able to visit a bustling expo hall that was full of industry leading companies and technology partnered with demonstrations.
Eager ears were in the Great Hall as guests were treated to significant local and international speakers including Daren Mochrie QAM (North West Ambulance Service), Dr. Yih Yng Ng (Ng Teng Fong Centre for Healthcare Innovation, Singapore), Dr Denise Bunting (Queensland Ambulance Service) and Jon Dee (Do Something).
Heading into its 16th year, the coveted Awards for Excellence is the night of nights on the CAA calendar with it being run on the opening night of Congress. After receiving and sifting through 50 submissions, Wellington Free Ambulance were the winners of three awards including the coveted Star Award.
After close to 30 scheduled speaking sessions, 29 combined mini masterclasses and demonstrations and a fantastic gala evening which celebrated the growth of the ambulance sector, we farewelled Congress in Brisbane, and turned towards Melbourne for 2024 Congress in August.
Building on previous years, the CAA continues to be a driver of Restart a Heart Day activations and out-of-hospital cardiac arrest awareness across the Australasian ambulance sector and their communities.
It was another successful Restart a Heart Day in South Australia as the CAA partnered with the SA Ambulance Service, Surf Lifesaving SA, St John SA and Flinders University to raise CPR and AED community awareness as well as to improve cardiac arrest survival rates.
The 2023 activation was held in Rundle Mall on Restart a Heart Day, where services showcased their skills, answered community questions as well as educated the community. Rundle Mall shoppers and workers regularly stopped with the team and had a go at practicing CPR on the mannequins available.
Across the CAA Australasian member services, a variety of activations were taking place, including a highly successful activation from Wellington Free Ambulance who had close to 450 attendees at Wellington Airport educating CPR and how to operate an AED.
Other activations taking place included several areas in Papua New Guinea through National St John PNG, Raintree Park in the Northern Territory hosted by St John NT and several locations across the West Coast in New Zealand, organised by Hato Hone St John.
The CAA MARCOMMS team implemented an updated Digital Media Kit for member services and businesses alike to download at their leisure. Within this kit included Facebook, Instagram, LinkedIn and then Twitter tiles as well as stories for the relevant platforms and an e-signature.
In its second year, the Women in Leadership Scholarship aims to encourage more women to step into leadership roles and to support the further development of current women leaders in ambulance health services.
The Scholarship was formed through the CAA Women in Leadership working group, who sought to address challenges and adversities for women in ambulance health services by encouraging leadership development and mentoring. Winning this scholarship allows a 12-month mentorship from Total Coaching Academy and two runners up receive a six-month course.
The scholarship is open to any female team member across the CAA’s Australasian members, including those who volunteer. With 99 applicants for the 2023 scholarship, the vetting process was rigorous and proved that the talent within the industry is prominent.
After the challenging judging process, from 99 applicants, 15 finalists were selected. Out of the top 15, NSW Ambulance had four finalists, Ambulance Victoria and Hato Hone St John had three while St John WA, St John NT, Ambulance Tasmania, SA Ambulance Service and Wellington Free Ambulance had one each.
At the 2023 Women in Leadership Forum held in Melbourne, saw Fiona Windsor of Ambulance Victoria awarded the Women in Leadership Scholarship for 2023. Fiona currently serves as a Senior Team Manager and describes her leadership style as people focussed and encourages teamwork and empowers colleagues to deliver clinical excellence.
Belinda Callaghan and Heidi McGuire of NSW Ambulance were runners up for the scholarship.
This scholarship was kindly donated by Julie Piantadosi of Total Coaching Academy, and kindly sponsored by RAPP Australia.
Continuing its development in 2023-2024, FIRST magazine has continued to grow its audience both domestically and internationally.
As the link between stories and services in the Australasian Ambulance Sector, FIRST is a platform for team members, businesses, researchers from across the globe to distribute their thought-provoking research, opinions and achievements alike.
During the preparation of the 2023-2024 issues of first magazines, the CAA team worked tirelessly and closely with member services as well as authors from around the world to ensure the utmost best content was to be included.
Alongside research, opinions and industry news, FIRST highlights and showcases the awards and events happening on the CAA calendar on a regular basis.
With a limited print run, FIRST magazine is predominantly promoted and distributed through online advertising including social media and Electronic Direct Mail (EDM). Aside from the limited physical copies, the continued growth and support of FIRST is astounding.
The Council of Ambulance Authorities are currently managing two websites, one for all CAA related events, activities and information and the other for Restart a Heart awareness and content.
Where required, cross promotion is utilised although both websites predominately run parallel with each other.
The caa.net.au houses the most up to date information coming from the CAA offices including reports, media publications, award finalists/winners as well as information regarding career progression and information.
Continuing from 2022-2023, the goals of 2023-2024 were very similar, continuing the timely updating of correct information as required. These websites have a strong user interface for visitors and has been further developed for visitors. By having the correct information updated where required, from a social media perspective, the MARCOMMS team have been able to direct all traffic from social posts to the website, therefore growing traffic and other SEO stats. By focussing on the driving of traffic to the caa.net.au or restartaheart.net websites, the trust from the audience rises and assists the CAA as the sectors peak body.
The CAA currently has an account on Facebook, LinkedIn, X, and YouTube to continuously post strong and relatable content to grow the audience. LinkedIn proves to be the best platform for the CAA with the most regular engagement and audience distribution. By experimenting with posting, there is a continuous learning of what type of content works best and when. With these learnings, the MARCOMMS team can schedule posts in advance on days and times that are optimal for a wider distribution and potential for more engagement.
Again, continuing from 2022-2023, the use of electronic Direct Mail (eDM) has been consistently used to distribute and break news as required. Since the creation, of the CAA account, there has been a consistent growth in audience which will continue to grow over time. Despite the varying levels of opens and/or clicks, this is a functional distribution network for the CAA/ Restart a Heart content.
Since the implementation of CAA
Webinars,
audience members have been provided valuable education regarding a wide range of topics.
Throughout 2023-2024, CAA Webinars held three programs that covered topics ranging from practical objects used in the field to emergency service mental health and wellbeing. These webinars were held by both academics and industry professionals including Jan-Thorsten Gräsner MD FERC, Ms Madeleine Juhrmann and Matt Newlands.
During this period, we have seen a drop of viewership on each of the videos in comparison to the 2022-23 period. This drop in viewership is a focal point going forward as these webinars are an opportunity for registered paramedics to claim required CPD points.
Looking toward 2024-2025, the CAA aims to continue Webinar production, although are also investigating alternative ways to inform, educate and entertain the audience to ensure the growth of service member participation and demand.
Heading into its 16th year, the coveted Awards for Excellence is the night of nights on the CAA calendar with it being run on the opening night of Congress.
After receiving and sifting through 50 submissions, Wellington Free Ambulance were the winners of three awards including the coveted Star Award. See all the award finalists and award winners below:
Star Award
The Star Award was awarded to Wellington Free Ambulance for their Review of Shift Pattern and Fatigue at Wellington Free Ambulance
Excellence in Technology
Finalists included Ambulance Victoria’s Video Assisted Secondary Triage, Ambulance Victoria’s Focus Analytical Dashboards, and Ambulance Tasmania’s Atoms - Ambulance Tasmania Online Medication System.
The winner of the Excellence in Technology Award went to Ambulance Victoria – 2021 Clinical Response Model.
Excellence in Clinical Practice
The Finalists were Ambulance Victoria for their Blood Component Access Project, Hato Hone St John’s EMT Fentanyl Initiative, and Queensland Ambulance Service’s Full Implementation of the Clinical Hub.
The winner of the Excellence in Clinical Practice Award went to St John WA – Leave behind Nalaxone.
Excellence in Staff Development
Finalists included Hato Hone St John’s Remote Triage, Queensland Ambulance Service’s Leadership Capability Development Framework, and St John WA’s Low Acuity Response Medic Pathway to Paramedic.
The winner of the Excellence in Staff Development Award went to St John WA –Critical Care Paramedic Internship.
Excellence in Patient Care
The finalists were Ambulance Victoria –A Strategy to Enhance Cardiac Arrest Survival After the Covid-19 Pandemic, Queensland Ambulance Service’s The Queensland Ambulance Service Falls Co-Response Program, and St John WA’s State Obstetric Referral Call (STORC). Midwives Join Frontline Ambulance Crews to Improve Maternity Care for Women and Their Families.
The winner of the Excellence in Patient Care Award went to Wellington Free AmbulanceCritical Care for Prehospital Telestroke.
Excellence in Leadership
Finalists included Ambulance Tasmania Working Flexibly at Ambulance Tasmania, Hato Hone St John’s Tactical Commander Training Framework, and St John WA’s Total Solar Eclipse 2023.
The winner of the Excellence in Leadership Award went to Queensland Ambulance Service’s Development of the QAS Strategy 2022-2027
Excellence in Mental Health and Wellbeing
Finalists included NSW Ambulance’s Mental Health First Responder – A Real Time Virtual Mental Health Triage Service, SA Ambulance Service’s Paramedic Telehealth Clinicians – Mental Health, and St John WA’s Inclusive Flexible Workplace Arrangements (FWA) to Support Work-Life Balance in Ambulance,
The winner of the Excellence in Mental Health & Wellbeing Award went to Wellington Free Ambulance’s Review of Shift Pattern and Fatigue at Wellington Free Ambulance
