Table 4

Policy review

RegionDocumentPublication dateHealth facility focusEMS focusSupporting quote for EMS guidanceRef
NationalA Policy on Quality in Healthcare for South AfricaApril 2007YesNoNil 12
“Towards Quality Care for Patients”
National Core Standards for Health Establishments in South Africa
2011YesNoNil 25
South African Department of Health Strategic Plan 2015–20192014YesYes Strategic objectives:
  • Ensure the effective and efficient delivery of Emergency Medical Services

  • Ensure access to effective and efficient delivery of quality Emergency Medical Services

26
National Policy to Manage Complaints, Compliments and Suggestions in the Public Health Sector of South AfricaJuly 2016YesNoNil 27
National Policy for Patient Safety Incident Reporting and Learning in the Public Health Sector of South AfricaJuly 2016YesNoNil 28
National Health Act, 2003 (Act no. 61 of 2003)
National Health Insurance Policy
2017YesYes Improving access to Emergency Medical Services:
156. A uniform level of quality for Emergency Medical Services (EMS) and Facility-based Emergency Care will be provided across the country according to nationally determined norms and standards in relation to the level of care, staffing requirements, prescribed equipment, suitability of response vehicles and ambulances and other relevant components based on the level of care.
29
National Health Act, 2003 (Act no. 61 of 2003)
Emergency Medical Service Regulation
December 2017NoYes Consideration of application for Licence:
(c) the need to promote quality services which are accessible, affordable, cost-effective and safe;
(h) where applicable, the quality of health services rendered by the applicant in the past;
30
Management of Emergency Medical Service:
(b) ensure that the Emergency Medical Service is operated in a way that provides quality care and does not compromise the safety of the public, patient or personnel;
(t) ensure that there are mechanisms in place for the management of complaints, consultation, clinical governance and quality assurance
Professional Board for Emergency Care Clinical Practice Guidelines2018NoYes Important Additional notes
All interventions and medications are to be performed and administered within the Clinical Practice Guidelines and a locally relevant standard of care. Clinical governance structures shall support these guidelines
31
Western CapeWestern Cape Ambulance Services Act, 20032003NoYes Norms, standards and quality assurance
7. (1) The MEC shall prescribe minimum norms and standards for the delivery of ambulance services which will include—
  1. equitable access;

  2. the use of volunteers;

  3. personnel, vehicle and equipment requirements;

  4. communication and co-ordination procedures; and

  5. systems to receive, investigate and remedy complaints.

32
Healthcare 20302014 Emergency Medical Services:
  • EMS district managers will closely support district health managers by providing EMS-related data for monitoring and evaluation

  • International benchmarking and best practice establish that EMS is best delivered as a provincial service rather than a local service.

33
Western Cape Government Health Annual Report2018YesYes Reported indicators:
  • EMS P1 urban response under 15 min rate

  • EMS inter-facility transfer rate

  • Total number of EMS emergency cases

34
KwaZulu NatalKwaZulu Natal Department of Health Strategic Plan 2015–20192015YesYes Priority 2: Improve the Efficiency of Emergency Medical Services:
  • Governance structures will be strengthened, and training of managers will be prioritized to improve management and quality.

  • Appropriate ICT infrastructure (including mobile data terminals) and computers will be installed at all ambulance bases to ensure access to on-line facilities to improve data accuracy and availability.

  • An appropriate electronic patient booking system will be introduced to improve appropriate response to emergency calls.

35
Quality improvement Intervention based on Patients Safety Incident (PSI)2016YesNilNil 36
KwaZulu Natal Department of Health Annual Report2018YesYes Reported indicators:
  • Total number of EMS clients

  • Total number of interfacility transfers

  • Percentage of response times to red codes (P1) within 15 mins for urban areas

  • Percentage of response times to red codes (P1) within 40 mins for rural areas

  • Cases attended to by Air Ambulance Services

  • Aeromedical Services utilisation per district

  • Ambulances per 10 000 population

37
North West ProvinceNorth West Department of Health Strategic Plan 2015–20192015YesYes Strategic Goal 2:
  • Improve the quality of care by setting and monitoring national norms and standards, improving systems for user feedback, increasing safety in health care, and by improving clinical governance.

38
North West Department of Health Annual Report2018YesYes Reported indicators:
  • EMS Operational ambulance coverage

  • EMS P1 urban Response under 15 min rate

  • EMS P1 rural Response under 40 min rate


EMS interfacility Transfer rate
39
LimpopoLimpopo Department of Health Annual Report2018YesYes Reported indicators:
  • Ratio of ambulances per population

  • Number of ambulances procured

  • EMS P1 urban Response under 15 min rate

  • EMS P1 rural Response under 40 min rate

  • EMS inter-facility transfer rate

40