Presented by: Dr O Mazwai

EMS and Aeromedical Services

EMS in Legislation˃ Constitutional mandate

˃ Negotiated Service Delivery Agreement, 2010-2014(NSDA)

˃ Re-engineering of Primary Health Care (PHC)

˃ HRH Strategy for the Health Sector: 2012/13 – 2016/17

NDoH EMS Directorate

EMS Training System

Aeromedical Services

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» Vision˃ To provide world class emergency medical services to the

communities of South Africa.

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» Purpose˃ To provide rapid effective and efficient emergency medical treatment

to our communities.

˃ Driven by the “golden hour”; basic principles of EMS are:

+ Preserve Life

+ Prevent Further Injury

+ Promote Recovery.

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1. Good response times

2. Standard Operating Procedures

3. Appropriate, functional equipment

4. Paramedical expertise

5. On-going training

6. Records integrity

7. Case Reviews

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Constitutional mandate˃ The provision of ambulance services is a Schedule 5 part A

responsibility in terms of the Constitution,

“ambulance services are a functional area of exclusive provincial legislative competence.”

˃ Section 27(3) of the Bill of Rights of the Constitution

“No one may be refused emergency medical treatment”.

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Negotiated Service Delivery Agreement, 2010-2014 (NSDA)

» Provision of Strategic Leadership

» Decreasing Maternal & Child Mortality˃ Specialised Obstetric Units with EMS support

˃ Provincial support in this is mandated!!!

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Negotiated Service Delivery Agreement, 2010-2014 (NSDA)

» Combating HIV / AIDS and Decreasing the Burden of disease from TB

» Strengthening Health System Effectiveness˃ Improved Human Resources for Health

˃ Improving Patient Care and Satisfaction

˃ Re-engineering of Primary Health Care (PHC)

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Re-engineering of Primary Health Care (PHC)

» EMS links˃ definitive curative care

˃ primary health care (& prevention).

» The NHI policy paper Calls for:˃ Re-engineering of PHC

+ quality, access & service delivery.

EMS is a support structure of this process

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HRH Strategy for the Health Sector: 2012/13 – 2016/178 sets of strategic priorities to increase the number and quality of the health care workforce in South Africa:

1. Leadership and governance2. Intelligence and planning for HRH3. A workforce for new service strategies4. Upscale and revitalise education, training and

research5. Academic training and service platform interfaces6. Professional human resource management7. Quality professional care8. Access in rural and remote areas

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Regulation

The purpose of regulation is to guide the sector to provide a uniform national standard of care

and safety to both patients and providers.

It encourages this standard to be efficient, equitable and sustainable.

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» Presently change is inevitable in EMS, the profession was developed about 3 decades ago and there was no master plan or strategy to guide its development and evolution.

» In line with the HRH Strategy, EMS education, training and research should be revitalised to meet health service demands.

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Higher EducationShort Courses

BAA

AEA

CCA

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2

3

N. Dip

4 B Tech

3 week

12 week

9 month

3 year

1 year

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EMS

Physical Resources

Vehicles

Land

AirWater

Equipment

Human Resources

Admin Operations

Crew

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Benefits of Aeromedical Services:

» Quality of Care (ALS minimum)

» Improved Access to specialised services

» Rapid transport

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FinancialDTI, Treasury, etc.

AviationCAA

MedicalNDoH

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Aeromedical - Financial constraints may lead to:

» Inappropriate aircraft type/size

» Inadequate medical equipment.

» Under-qualified, under-experienced, under-subscribed medical crew*

» Reduced quality care

» Inappropriate & unnecessary flights*

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EMS Systems:

» Present management structure & efficiency,˃ (there is sub-optimal management of EMS in general)

˃ Poor effectiveness regarding service delivery

» Insufficient funding˃ Shortage of resources

˃ Inequitable access to EMS

» Poor income generation˃ lack of accountability – no PRF/invoicing for EMS provided

˃ Poor debtor collection

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19Thank you

Questions?