For information
on 20 November 1997


Provisional Legislative Council
Panel on Security

Emergency Ambulance Service

Introduction

This paper outlines the measures being implemented by the Government to improve emergency ambulance service run by the Fire Services Department (FSD).

Background

2.In 1986, a consultancy study was conducted on the provision of ambulance services in Hong Kong. In 1995, a second consultancy study was conducted by the same consultant to update the findings of the 1986 study and to provide advice on how to improve the delivery of emergency ambulance cover in a cost-effective manner. Our programme to improve emergency ambulance service has been largely based on the recommendations of these studies.

Performance Target

3. Our current target is to respond to 92.5% of all emergency calls within a ten-minute travel time, i.e. from the time of despatch to the time of arrival at scene.

4.The performance of the emergency ambulance service in the past 3 years are as follows -

Year No. of emergency calls answered by FSD % of calls reached within the 10-minute travel time
1996 347,607 89.7
1995 317,749 89.5
1994 289,289 91.7

5.The consultant recommended that FSD should ultimately aim to use response time i.e. from the time of receiving a call to the time of arrival at scene, as the performance target. However, the consultant has also pointed out that with the current achievable travel time and distribution of demand, the first priority should be to make the best use of available resources to meet the target for responding to calls with the 10-minute travel time. We are seeking to achieve this target for 92.5% of the calls and then eventually to 95% of the calls. FSD is actively studying the feasibility of switching to response time. FSD has initiated a trial scheme to use a new trunked radio system in September this year to record response times. This trial scheme will be run from September 1997 to March 1998. Data collected will be used to assess the suitability of using response time as an indicator of the performance of emergency ambulance service.

Improvement Measures

6.A list of 1995 consultancy recommendations that have been completed is at Annex A. We have also been actively implementing those longer term measures which require additional resources.

7.Resources have been secured for the provision of 222 posts to improve performance of existing ambulance depots territory-wide over two years - 165 posts for phase I (97/98) and 57 posts for phase II (98/99). 45 posts are also provided for the two new ambulance depots at Tung Chung and Sham Tseng. Recruitment and training of staff are being carried out in full swing. 27 additional ambulances and 11 Ambulance Aid Motor Cycles, together with 72 ambulances for replacement are also provided in 1997/98 to improve the performance of emergency ambulance service.

8.As recommended by the consultant, additional ambulance depots will be built to improve the coverage of emergency ambulance service in the territory. The proposed Kowloon Tong and Mong Kok Depots have been upgraded to Category B in the Public Works Programme. Suitable sites in Sheung Wan and Kwai Chung have also been earmarked for depot development.

9.In addition to the above, FSD has initiated other improvement measures to further enhance the quality and efficiency of its emergency ambulance service. Such measures are set out at Annex B.

Conclusion

10.We are committed to achieving the performance target on emergency ambulance service. We are closely monitoring the effects of our package of measures to improve performance. New posts are being created and training of recruits are being carried out in full swing. We are also taking active steps to build additional ambulance depots to improve the emergency ambulance coverage for the whole territory. We expect to start seeing the improvements brought about by the additional resources and our improvement measures in 1998/99, when the new recruits have completed their training and render active service, and additional ambulances have been commissioned. However, it will take more time for us to see the total effect of the package of measures until they have been fully implemented.


Security Bureau
14 November 1997

Annex A

Recommendations of the Consultancy Study in 1995 completed by the Administration

  1. To extend emergency cover to fire stations at strategic locations.

    2. Ambulances redeployed as recommended.

  2. To redeploy ambulances from well-provisioned stations to those where manning is inadequate.

    3. Resources redeployed as far as practicable according to the consultant's recommendation.

  3. To transfer non-emergency ambulance service to another agency.

    4. All non-emergency cases transferred to the Hospital Authority and the Auxiliary Medical Service.

  4. To include the turn-outs of Ambulance Aid Motorcycles (AAMCs) in the calculation of emergency ambulance performance.

    5. Contribution of the AAMCs in achieving target performance has been included and FSD will continue to maximise utilisation of the AAMCs in emergency response.

  5. To streamline the operational procedures on ambulance deployment to achieve a more efficient mobilisation.

    6. Recommended measures which include more flexible use of available crews on mobile and at hospital, more rational and effective move-ups, etc have been adopted.

Annex B

Additional Measures taken by FSD

  1. At present over half of the ambulance fleet is equipped with automatic defibrillators. We will upgrade the ability of ambulance crews to deal with cardiac conditions by equipping all ambulances with automatic external defibrillators in early 1998. FSD will also commission the second Mobile Casualty Treatment Centre by the end of 1997 to improve the ability to deal with multiple casualties incidents. We are planning to procure a third Mobile Casualty Treatment Centre to further improve our service.

  2. FSD has initiated a project to equip all ambulances with hand held radio sets to supplement the existing radio telephones. The project is expected to be completed in 1998. The communication amongst ambulances crews and the Fire Services Communication Centre would be significantly enhanced and operational efficiency can thus be improved.

  3. As part of the development programme of the paramedic ambulance service, FSD has engaged a medical doctor as the department's medical director in April 1997 to provide advice and assistance in the paramedic training programme, including the establishment of a quality assurance programme for the paramedic service.

  4. Refresher/continuation training programmes are organised for FSD staff to enhance their professional skills and knowledge. Overseas training programmes are also arranged annually for officers to keep abreast of the latest ambulance techniques and technology.

  5. Commencing 1997, FSD has started a programme to replace old ambulances with newly designed ones to provide better patient comfort and operational efficiency.

  6. The provision of medical equipment on board of ambulances is under constant review. Apart from the various improvements in ambulance equipment, burn dressings specifically designed for front line ambulance use have been employed to render the most expeditious and suitable stabilising treatment to patients suffering from burns and scalds. A new oxygen resuscitation system is also being procured to replace the existing oxygen ventilators of ambulances to keep up with the latest development in emergency service.