This follow-up audit assessed if the DoH and SJA have effectively implemented the recommendations from our 2013 audit Delivering Western Australia’s Ambulance Services, and have improved service management and delivery.

We also looked closely at ambulance delays at EDs resulting in ramping to assess its impact on patients and other parts of the health system.

In conducting the audit, we:

• reviewed policies, procedures and key documents
• interviewed key staff in the DoH, WACHS and SJA
• visited 5 metropolitan hospitals, visited or spoke to 9 country hospitals, visited the SJA State Operations Centre and visited 5 SJA ambulance centres/sub-centres
• considered relevant academic research.

In addition, we analysed the DoH and SJA data from July 2012 to April 2019.

We did not analyse the economic impact and cost of ramping or of the contractual arrangements for IHPT in country and metropolitan areas.

This was a performance audit, conducted under section 18 of the Auditor General Act 2006, in accordance with the Australian Standard on Assurance Engagements ASAE 3500 Performance Engagements. This audit utilised ‘follow-the-dollar powers’ under section 18 of the Auditor General Act 2006. We complied with the independence and other ethical requirements related to assurance engagements. Performance audits focus primarily on the effective management and operations of entity programs and activities. The approximate cost of undertaking the audit and reporting was $327,700.