TNAG-1619-FCO40-2228-Executive-Council-of-Hong-Kong-memoranda-and-minutes-of-meet-1987 — Page 119

7.1

CO-ORDINATION WITH HOSPITALS

These

The future manpower requirements estimated above are based on the assumptions regarding the expansion of routine work which are discussed in the Report on Routine Services. assumptions are subject to considerable uncertainty as new health facilities are developed and the expectations of the population increase.

7.2

It

must be emphasised that this expansion could become unmanageable, especially under a single tier service with a combined Control, in which case the standard of emergency cover could become jeopardised in the day shift. With a tiered system and two Controls, as recommended in this study, and with the manning levels estimated above, services should be provided in an orderly manner. However the quality of service which routine patients receive is likely to fall as the numbers increase, both in terms of waiting times and trip lengths, if services continue to be provided on the present basis.

7.3

To improve the service to patients and the efficiency of routine transport operations, hospital co-operation is essential. The present pattern of ad hoc requests for transport makes efficient scheduling and routing impossible. One form of Co- operation would be for most transfers and discharges to take place at given times, especially at the main hospitals. Regular runs at pre- determined times, especially if these were staggered So as not to coincide with geriatric day care journeys, would considerably improve the efficiency of services. Pre-arranged ambulance arrival times would also encourage orderly discharge arrangements at hospitals and possible shorter waiting times patients.

7.4

were

for

a

However, the maximum benefits would be realised from system of advance booking for routine transport. If requests transmitted 24 hours in advance, or at least by 6 pm the previous day, journeys and loads could be planned before each day's operations to yield the best possible pattern of journeys and vehicle utilisation. Route planning would form part of the tasks of a separate routine control function.

7.5

·

Up to 20 fewer crews (fourteen two-man and six three-man crews) would be required on the day shift under such a system, ie. up to 50 ambulancemen. The vehicle loading for routine work (at present an average of 2 patients per journey) could be almost doubled. Waiting times could

reduced and criteria for

be

providing transport could be more closely monitored.

7.6 The present high throughput at the acute hospitals depends on the transport of patients, often in frail condition, by Ambulance Command. If these transport services were not to

available, either the acute hospitals would not be able operate the way they do at present or Medical and Health Department would have to organise the required transport. Thus there

is a good case for hospital

implementing new procedures which make concessions

in improving ambulance service efficiency. The control of demand by a system of charging is not recommended in the near future as briefly discussed in Section 4.4 of the Report on Routine Services.

staff to

help

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