Ambulance officers in a regional Victorian town are urging the state government to abandon its planned change of staffing rules at its station at the end of next month.
- Changes beginning on June 28 say there must be two paramedics in an ambulance
- St Arnaud only has two paramedics and the workforce is supplemented by ambulance community officers
- Staff fear the changes will result in less ambulance coverage, but the union refutes the claim
From June 28, there must be two paramedics in each ambulance at St Arnaud station, a move advocates say will improve the level of care given to regional patients.
Currently, there is one paramedic and one ambulance community officer (ACO) in each of the town’s two vehicles, allowing both ambulances to service the community at any one time.
Paramedic Nick Green said the change would halve their service to the town of 2,200 people.
“If we go to the new roster there is a massive issue with fatigue, which will lead to less coverage by our paramedics in the town,” he said.
“If we stick with the roster we are currently running — with the demand as it is and due to the geographical location of St Arnaud — that is a much better outcome.”
Staff from the station have written to the Member for Ripon Louise Staley about their concerns.
What are ACOs?
Like paramedics, ambulance community officers are first responders employed casually to work on-call.
Ambulance Victoria said there are 1,033 ACOs statewide, trained to offer advanced first aid in remote Victorian communities in areas where the caseloads are low and branches not staffed full-time.
They can transport patients to the hospital and support paramedics.
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Paramedics are trained to a higher level — known as advanced life support (ALS) — to administer drugs for pain relief and cardiac arrest.
The paramedics in St Arnaud work a 10-hour shift and are on-call for the remaining 14 hours. They can ask for 10-hour-long rest breaks if they are too tired to respond to new incidents.
Under the current roster, paramedics in the town can run two ambulances on weekdays and one on weeknights and weekends.
It will become one at all times under the new system.
Greg Fithall, who was awarded the Ambulance Service Medal earlier this year, is one of a dozen ACOs on a 20-hours-a-month contract in St Arnaud.
He said staff at the ambulance station regularly transport patients to hospitals in Horsham, Bendigo and Ballarat, which have the nearest emergency departments.
Mr Green said he was regularly sent to jobs in Charlton, Donald and Bridgewater — neighbouring towns all more than 40 minutes drive away — when he was the closest paramedic.
Mr Fithall said this would become more common under the new system.
He said branches with two or more ALS paramedics would need to respond to incidents in towns without them — including Wedderburn, which is staffed by Community Emergency Response Team volunteers (CERTs).
“Our roster system is the only one of its kind in Victoria,” he said.
“We go to Charlton, Avoca and Rupanyup to cover [paramedics on] their fatigue breaks. Once we all go to the new system, their fatigue breaks will change and we won’t have a spare ambulance to relieve them.”
The perceived risk
Mr Green said the lack of healthcare options in the community made the ambulance service even more vital.
“With the new model, if we end up transporting someone over an hour away, our turnaround time could be five to six hours, and the community will not have an ambulance in it for that duration,” he said.
Critical shortage of ambulance crews across Sydney
The union covering paramedics says a critical shortage of ambulance crews across Sydney earlier this week shows a wider problem for the emergency network.
Mr Green said the ambulance station responded to anywhere between 50 to 80 jobs per month.
He said Ambulance Victoria management personnel were set to visit town to hear his concerns later this week, but as far as he knew “no one’s really been consulted [on the changes] at any stage”.
“It’s all just happening because it’s a directive that has come from the state government and the union,” he said.
Ambulance Victoria data shows paramedics in the Northern Grampians Shire responded to 58 per cent of Code 1 call outs in under 15 minutes in the three months to April 2021, down 10 per cent compared to a year earlier.
In the surrounding Buloke and Loddon shires, that figure was 34 and 27 per cent respectively. Compared to the previous year, responses in Buloke remained stable but data showed Loddon had an annual drop of 10 per cent.
Ambulance Victoria’s targets require all vehicles to respond to 85 per cent of Code 1 call-outs within 15 minutes.
Union questions St Arnaud concerns
In 2018, St Arnaud only had one paramedic, and was one of 12 priority locations the state government said it would add a second to if re-elected, which it was in November of that year.
Victorian Ambulance Union secretary Danny Hill said it had secured a commitment for more paramedics from the state government.
He said residents did not have to be concerned about the upcoming staffing changes in ambulances.
“The union secured funding to actually pay for more paramedics to be sent out and permanently located at a lot of these locations, so from my point of view it can only be seen as a good thing to get more paramedics into those smaller country towns,” he said.
“There is also nothing to say that use of two vehicles can’t still happen. Most branches, whether they are single officer or not, have two vehicles, so it common to see different arrangements occur.”
Mr Fithall said after taking fatigue management into account, St Arnaud would need eight paramedics to run two two-paramedic ambulances on weekdays under the new system.
Local politician Louise Staley said the number of paramedics would need to double for the new staffing system to improve the response rate.
Avoca to get another paramedic
A government spokesman said the government had been speaking with ambulance staff about upcoming conversions, with Avoca next to receive a second paramedic.
He said while Ambulance Victoria had to adapt, ACOs were part of the future of frontline healthcare delivery.
“The Victorian Budget 2021/22 will deliver more than $759 million in funding for more paramedics, more triage care and support staff for Ambulance Victoria, as well as targeted funding to improve flow in our busy emergency departments across the state,” he said.
“We will continue working closely with experts from our health services, ambulances services, workforce representatives and primary health services to determine where the need is most and how we can best address it.”