This report contains the findings from my Office’s follow-up performance audit of the delivery of ambulance services.

The audit shows mixed results on the implementation of the Office’s 2013 recommendations. Overall, the WA ambulance service is operating more efficiently and consistently meeting its highest priority emergency response targets. Many of our previous findings and recommendations have been addressed, strengthening clinical governance and improving support for country volunteers.

In other areas, however, there has been little progress. Specifically, in putting in place a funding model that links standards, performance and risk to cost, and a contract that creates direct accountability for ambulance performance, underpinned by strong data sharing and analysis. This continues to hamper the Department of Health and St John Ambulance WA in clearly demonstrating that the service offers best value for money to government and best possible clinical outcomes for patients.

The nature of the relationship between the Department and St John is in many ways unique, based on almost a century of history and deep roots in the Western Australian community. Services are delivered by highly trained and dedicated professionals, including a large volunteer workforce in country areas.

I acknowledge the work over the last 5 years by the Department and St John to continually improve the service to meet the evolving needs of Western Australians. Ongoing commitment and perseverance will be essential to address ambulance ramping at hospitals. The causes of ramping are not simple, nor are potential solutions. The entities need a shared understanding of both the nature of the problem and its impact, and what each might do to improve their parts of a patient’s journey from the call for an ambulance to treatment in hospital.