Advisory AS23/02: Advice on not applicable actions for Ambulance Health Services

Advisory details

Purpose

To clarify not applicable actions for ambulance health services.
 

Issue

In some exceptional circumstances, actions from the NSQHS Standards may not be applicable to an ambulance health service. The Commission has issued this advisory to ensure the consistent application of not applicable status to actions within the NSQHS Standards.

Where an ambulance health service considers that an action is not applicable, evidence must be supplied to demonstrate that the action is associated with little or no risk of patient harm in the context of the service provided. Applications should be submitted to the relevant approved accrediting agency well in advance of the assessment. Accrediting agencies are to provide an initial determination of the ambulance health service’s submission before undertaking the scheduled assessment. At assessment, assessors are to verify that the decision to award these actions not applicable status is justified.

To be not applicable, an action should not be applicable in any part of the service.  If an action is applicable in part but not all of the service, it is only assessed in areas where the action is relevant. 

Infrequent application of an action, is not sufficient reason for awarding not applicable status, as it may present a significant risk to a patient. 

Ambulance Health Services

For the purposes of this Advisory, ambulance health services means a multi-disciplinary mobile and/or out of hospital health service that may provide a complex range of emergency, urgent and non-urgent clinical care, patient transport, retrieval and in some cases rescue services to the community.  Ambulance health services may work in partnership with other health agencies and service providers in the community, providing some or all of the following: 

•  Emergency or unscheduled health response, primary retrieval, and out of hospital care
• Emergency health transport by road or air including secondary retrieval of patients to other facilities
• Scheduled patient transport (including road and air stretcher transport and clinic transport for walking and wheelchair patients)
• Service models that integrate with the wider health system linking ambulance patients to appropriate pathways of care including unscheduled virtual clinical care and community paramedicine
• Support for other health services in communities where the full range of services are not easily accessible.
   

Requirements

The attached tables detail the actions which may be awarded not applicable rating where the ambulance health service provides supporting evidence the action is not relevant to the service being provided.

Accrediting agencies are required to refer to the below tables when considering applications from ambulance health services for not-applicable actions.

Where differences in opinion concerning an award of not applicable status that is not resolved following discussions between the ambulance health service and the accrediting agency, application can be made by either the accrediting agency or ambulance health service to the Commission for resolution.
 

Attachment: Summary tables of not applicable actions