St John Ambulance NT: NT Health puts ambulance provider under the microscope in new review

Both NT Health and St John Ambulance NT have downplayed the significance of a forensic review into the emergency services provider, saying the review is a standard part of contract negotiations.

St John Ambulance NT units ramped at the Royal Darwin Hospital. Picture: Alex Treacy

The health department has ordered a forensic review into the operations of the Territory’s emergency ambulance provider, St John NT, the significance of which both parties have downplayed.

According to an NT Health spokeswoman, the review is a “standard quality assurance activity and is part of ongoing improvement processes for contract management”.

The review will “evaluate the effectiveness of clinical governance structures and processes in place for clinical practice, identify areas of strength and opportunities for improvement in the delivery of paramedic and pre-hospital services, [and] assess the alignment of paramedic practice with relevant national and international standards, guidelines, and best practices”.

It will be undertaken by an external clinician, Dr Craig Ellis, who is currently the medical director for St John New Zealand and has previously worked on secondment at the Royal Darwin Hospital’s emergency department.

“A wide range of stakeholders in both Darwin and Alice Springs have provided input as part of the review, including staff, relevant union representatives and external stakeholders,” the spokeswoman said.

“NT Health will continue to work collaboratively with St John NT upon receipt of the review’s recommendations, to ensure best quality care for all Territorians.”

St John NT director of ambulance services Andrew Thomas said his organisation “welcomes the external review of our clinical governance structures and systems”.

St John Ambulance NT director of ambulance services Andrew Thomas. Picture: Alex Treacy

“The review is being conducted in collaboration with NT Health and is a standard quality assurance process as part of the management of our contract with the NT government,” he said.

“In order to support this process, we will refrain from making further comments until we receive the final report and any suggested improvements to our ambulance services to the Northern Territory.”

Despite the official bonhomie, the terms of the review, which were leaked to the NT Independent, appeared to contain a sting in the tail for St John NT.

Dr Craig Ellis. Picture: ANZICS

“Following on from recent clinical cases where there has been concerns raised and investigations undertaken on these cases, and to improve the safety culture and processes for reporting of clinical concerns between NT Health facilities and St John NT, the commitment to review the clinical governance systems and reporting processes between NT Health and St John NT has been established,” the terms reportedly state.

St John NT sources declined to elaborate further on this wording.

“It’s written in there like it’s a punitive review, but it’s not, it’s forming part of the ongoing discussions around contracts,” one said.

Another pointed out that there have “been reviews of ambulance services before,” citing the review undertaken by Professor Neale Fong in 2017.

That review found that, overall, the St John NT “functions well … [but] there are many aspects that require significant reform”.

Professor Fong made 44 recommendations, 21 of which were specific to St John NT, falling under two broad categories: boosting the workforce and volunteer pool, and strengthening clinical governance.

Earlier this year, the NT News reported that the organisation was under significant strain owing to an enormous rise in demand couples with declining government funding.