AMBULANCE VICTORIA STRATEGIC PLAN 2010 – 2012

5. The Planning Environment
Eleven key challenges have been identified, which AV will need to address
during the planning period and beyond.
Increasing demand for services
Ambulance services in Victoria have been under stress as a result of continuing
strong growth in demand for more than a decade. Since 1999-2000, ambulance
caseload in Victoria has grown by an average of 5.7 per cent per annum, with
both emergency and non-emergency incidents increasing by more than 50 per
cent. Other ambulance services around the world are experiencing similar
demand pressures.
Demand management has been an important focus for more than five years.
The referral system for lower priority 000 callers in Melbourne has played an
important role in controlling demand, with more than 7 per cent of callers not
receiving an emergency ambulance dispatch. There is scope for expansion
of the service and exploration of new emergency demand management
initiatives. Management of non-emergency demand, and ensuring
appropriate allocation of resources to meet patient needs will also be a
priority. These strategies will assist in moderating growth, but increasing
demand is expected to remain a key challenge through the planning period.
The drivers of ambulance demand are similar to those affecting demand for most
other health services. These include demographic change (ageing and population
growth), which accounts for about 25 per cent of the increase in emergency
demand. Trends in the health of the community play a key role, notably the
increasing burden of chronic disease. Other factors also include changes in
medical practice and patient management (e.g. the trend to early discharge
and treatment in the community), social changes (e.g. the increasing number of
people living alone), reduced accessibility to other health services in some areas
(especially general practitioners) and rising community expectations.
Growth has slowed in the last eighteen months, but there is no reason to believe
that the long-term trend has changed. Large numbers of seriously ill patients
(about 40 per cent of triage category 1 to 3 patients in Melbourne) are not
transported to hospital emergency departments by ambulance, indicating there
is significant potential for further increases in demand.
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