St John to adapt to handle growth

Ambulance resources around the country look set to change as St John works out how to deal with record numbers of 111 calls, expected to surpass 500,000 nationally within five years.

The new man at the helm of New Zealand's largest ambulance service provider, Peter Bradley, warns that public expectations will need to change if it is to balance demand with a Ministry of Health directive to reduce emergency department presentations.

"If you ring 111 we might offer advice, refer someone to a GP or even send a car rather than an ambulance," Bradley said.

But the former head of the London Ambulance Service said his No 1 priority would be the patient, not the bottom line.

"Where I have come from we had to make massive cost savings, so I am used to working in that sort of environment, but one thing I am clear on is that we will not be making savings that affect patients.

"I don't think we as a senior management team have been as focused on patients as we should have been, and I am here to try and strengthen that - and all the other things we need to do," he said.

The 54-year-old arrived in New Zealand soon after the London Olympics and has spent his first three months visiting St John stations around the country and meeting several district health boards.

The Ministry of Health has asked St John to help reduce ED presentations by 80,000 by assisting with community-based healthcare. It's a challenge that Bradley is keen to meet.

"There are great opportunities here to improve patient care and do more work with DHBs around stroke, trauma and patient care and play more of a clinical leadership role - we need to be more up front and leading that kind of work," Bradley said.

St John is crunching the numbers as it develops a strategic model to meet the expected growth in workload.

"It may be that we have some tough decisions to make about where we spend our money, if we believe we don't have enough staff then we just can't rely on the good ones to bail us out, we have to change the way we work and look at our entire organisation as a whole."

St John is working on national staff and resource plans to ensure that staff and vehicle levels are meeting call volumes.

Bradley admits that in some areas, such as rural Waikato, the mix is not right.

"I think there are some areas of New Zealand that are definitely understaffed," he said.

"And it's fair to say there are areas of the Waikato where there are more ambulances that are single crewed but doing high volumes of work, and that needs to be addressed."

Bradley has a firm view on the Fire Service being sent to emergency medical calls - an issue that has concernedfire chiefs.

"I agree with co-responding, but not as a sole response," he said.

"I think it is crucial the calls they are going to are the calls they are trained to deal with."

A medical-based memorandum of understanding between St John and the Fire Service is under review and Bradley expects to have a lead role in any outcome.

"It needs to be very carefully dealt with.

"Nothing has been finalised and I will have a very close and personal assessment of that."

Despite the challenges that lie ahead, the Auckland-based chief executive is excited about the future, even with the projected growth in workload for St John.

"But if we know that now we can plan for it - in terms of resource, stations, staff and vehicles.

"That is exactly what we have just done in England and now we are about to go through that process here - preparing for our future."

The Press