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Saturday, February 24, 2007
Community Hospital , Mobile Clinic, Ambulance
1. How to apply for a Community Hospital licenceThe application for a hospital licence can be made through theelectroniclicence application system at
https://www.moh-ela.gov.sg. Thewebsitealsocontains an advisory page to guide you in the application process.2. How to apply for a Mobile Clinic licenceYou need to apply for a healthcare institution (eg hospital orclinic)licence such that the mobile medical services operateunder theauspicesofthe licensed healthcare institution.3. How to apply for a Ambulance licenceNo licence is required for the provision of ambulance service.However,ifyou intend to provide ambulance services, you would need to registeryourambulance/s with the Land Transport Authority (LTA). MOH assists LTAinassessing the professional capabilities of the ambulance serviceoperatorprior to their registration with LTA. . Our assessment is based ontheability of the applicant to comply fully with MOH's Guidelines forPrivateGUIDELINES FOR PRIVATE AMBULANCE SERVICEINTRODUCTIONThese guidelines are for the reference of agencies operating orintending tooperate a private ambulance service. The guidelines spell out theminimum requirementswhich the agency must meet when operating a private ambulanceservice. They coverthree areas:• Ambulance agency• Ambulance vehicles• Ambulance crewSection A deals with the Guidelines for Non-emergency AmbulanceServiceSection B deals with the Guidelines for Emergency Ambulance Service23 April 98 (MOH guidelines)2SECTION AGUIDELINES FOR NON EMERGENCY AMBULANCE SERVICE1 Definition1.1 A Non-Emergency Ambulance Service is one that providesambulances forferrying non-emergency patients ega. Patients requesting for ambulance for regular outpatient clinicattendance.b. Patients requesting for ambulance for transport to hospital withmedicalproblems that fulfil MOH criteria for non-emergencies (Appendix 1).c. Inter-hospital transfers of non-critically ill patients.d. Patients discharged from hospital to home.1.2 In spite of the above, it must be remembered that such non-emergencypatients may occasionally develop acute emergency problems while en-route in theambulance.2 Non-Emergency Ambulance Agency2.1 The Agency that intends to provide the service must be a companyor abusiness entity registered with the Registry of Companies &Businesses or a bona fideregistered voluntary or charitable organisation.2.2 The Agency must have the following:a. A qualified person (either a doctor or a nurse) employed by theAgency whosets protocols of care for patients transported and organisestraining andsupervision for medical care provided by ambulance crew. Voluntaryorganisations must also provide for a qualified person to supervisetheservice.b. A programme for training and monitoring performance levels ofambulancecrew and records of such performance monitoring.c. Acceptable scales of ambulance equipment and ambulance medicalsupplies (see Appendix 2).d. A system for activation of the ambulances of the Agency.3 Non-Emergency Ambulance Vehicle3.1 The ambulance vehicle shall meet the vehicle specifications setby the LandTransport Authority (LTA).3.2 The minimum equipment in each ambulance should be as spelt out inAppendix 2. These equipment should be serviceable at all times whenthe ambulance is inoperation.34 Non-Emergency Ambulance Crew4.1 Each Non-Emergency Ambulance should be staffed by at least a twomember crew, one of whom is a driver, and the other the AmbulanceOfficer who may beeither a Registered Nurse or trained Paramedic.4.2 The Driver should have the following minimum qualifications/experience:-a. Possess a valid licence to drive the ambulance.b. Understand the usage of ambulance stretchers.c. Undergone training in Standard First Aid.d. Trained in defensive driving and be well aware of the use ofsirens andflashing lights for conveying emergency patients to hospital.4.3 The Ambulance Officer should be able to :-a. Measure vital signs eg pulse rate, respiratory rate, bloodpressure.b. Perform Basic Cardiac Life Support (BCLS) and be currentlycertified inBCLS.c. Use airway adjuncts such as oropharyngeal airway, nasopharyngealairway,suction devices and basic oxygen delivery devices such as bag valvemask.d. Use various types of stretchers and body immobilisation devices.e. Perform basic emergency procedures such as:-i. Control of external bleedingii Application of dressings, bandages, slings and splints.f. Monitor peripheral lines of stable patients.g. Transfer and maintain patients with nasogastric tubes and urinarycatheters.h. Establish contact with a receiving hospital if the need arises.
