11 March 2025
Rodney Parsons
[FYI request #28960 email]
Tēnā koe Rodney
Your request for official information, reference: HNZ00077971
I refer to your follow up email on 3 February 2025, asking Health New Zealand | Te Whatu Ora
(Health NZ) for the following under the Official Information Act 1982 (the Act):
Your response says that ambulance providers are trained to manage mental health issues,
describe that training that you claim exists.
You point to an incident management process. Outline the number of mental health
incidents that have been raised with Te Whatu Ora in pre-hospital environments.
Prior to this change by police, ambulance services provided a given level of service. You
seem to indicate that there is no difference between the work undertaken before and after
the change my police. Is this what St John and Wellington Free Ambulance have advised
you? What steps has Te Whatu Ora taken to address and change in volume, complexity,
quality or safety of pre-hospital presentations following the change? Lastly, police have
ceased transporting mental health patients- outline what steps Te Whatu Ora have taken to
plan a response, given that this change occurred in November 2024.
Response
For clarity, I wil respond to each question in turn.
Your response says that ambulance providers are trained to manage mental health issues,
describe that training that you claim exists.
We note that your original request asked how we were keeping staf safe and accordingly our
answer focused on ambulance staff safety. The following expands on that answer, while also being
relevant to the above follow up question relating to mental health issues. Further questions
regarding this topic wil be treated as new requests under the Act.
Health NZ and the Accident Compensation Corporation (co-purchasers of emergency ambulance
services for the Government) and ambulance service providers are committed to keeping
ambulance personnel safe when out on calls and dealing with members of the public. Hato Hone
St John (HHStJ) provides staff with specialised training courses related to risk assessment and
management including the Ambulance Operations Risk Management (AORM) course and, in
extremis, Active Armed Of ender training.
The AORM course is a two-day course for all newly onboarded staff that was refreshed and went
live in July 2022. It is delivered by Clinical Support Officers and focuses on key and critical risks to
ambulance personnel, including violent and aggressive interactions. During the course, staff learn
and practice skil s such as dynamic risk assessment, professional communication and de-
escalation, and physical disengagement. Prior to the course, staff must complete 10 online
learning activities, two of which relate directly to dynamic risk assessment/interactions with volatile
patients.
Additionally, to assist HHStJ staff attending incidents in assessing and managing risks both prior to
and during an incident, HHStJ utilise Patient Care Plans. These plans help identify individuals with
a tendency of aggression or those requiring police involvement. Additionally, HHStJ flag high-risk
addresses to enhance situational awareness.
During incidents, frontline staff assess risk using the BATOMII (Behaviour, Af ect, Thought,
Orientation, Memory, Intellect, Insight) Mental State Examination, a well-known tool for evaluating
a patient’s mental state and potential risks.
You point to an incident management process. Outline the number of mental health
incidents that have been raised with Te Whatu Ora in pre-hospital environments.
On 13 February 2025, Health NZ emailed you asking if you’d be wil ing to refine this part of your
request in order to enable us to respond. We have not received a response. As such, this part of
your request is refused under section 18(f) of the Act, as the information cannot be made available
without substantial collation and research.
In accordance with section 18A of the Act, I have considered whether fixing a charge for the supply
of the information or extending the timeframe for response would enable Health NZ to respond. I
do not consider that either option would remove the impact that supplying the information would
have on our other operations.
Prior to this change by police, ambulance services provided a given level of service. You
seem to indicate that there is no difference between the work undertaken before and after
the change my police. Is this what St John and Wellington Free Ambulance have advised
you? What steps has Te Whatu Ora taken to address and change in volume, complexity,
quality or safety of pre-hospital presentations following the change?
Health NZ continues to work closely with emergency ambulance providers nationally to ascertain
any impact. At this stage, there has not been a significant change in level of service following the
implementation of Phase One of the Police Programme of Change.
In regard to steps taken by Health NZ to support ambulance service providers, this was underway
prior to the Police Programme of Change. This includes the $21 mil ion uplift in funding to HHStJ in
October 2024 and the work being done with those providers to ensure their needs are met, as laid
out in our previous response to you (our ref. HNZ00070448).
Lastly, police have ceased transporting mental health patients- outline what steps Te
Whatu Ora have taken to plan a response, given that this change occurred in November
2024.
Police have not stopped transporting mental health patients but rather have changed the threshold
for assistance to ensure Police are providing the appropriate response to need. Police have
committed to continue responding to any calls where an offence is being commit ed or there is an
immediate risk to life or safety, including any risk to safety within our hospitals.
How to get in touch
If you have any questions, you can contact us at
[email address].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may proactively
release a copy of this response on our website. Al requester data, including your name and
contact details, wil be removed prior to release.
Nāku iti noa, nā
Danielle Coe
Manager (OIAs) – Government Services
Health New Zealand | Te Whatu Ora
TeWhatuOra.govt.nz
Health NZ, PO Box 793,
Wel ington 6140, New Zealand
