National Policy on Ambulance Use and Services

Background and health service covered

Ambulance service is a vital health service for pre-and post hospital care to a sick patient or an injured patient resulting from an emergency or a disaster.
Ambulance service includes transporting the patient from the incident site to the emergency room of the receiving hospital for definitive care.
Ambulance service includes transferring the patient to another hospital for further diagnostic and treatment purposes.
Ambulance service includes rendering emergency medical care and life support to sustain the patient’s stability in transit to and from the hospital.
Ambulance service includes transporting medical care providers, blood, and emergency supplies.

Policy objective and governing purpose

The policy provides guidance for the proper design, equipping, staffing, and utilization of ambulance services.
The policy aims to protect and save lives of patients.
The policy enables medical care providers to properly perform their corresponding duties.

Scope and coverage of ambulance providers

The policy applies to all hospitals, health facilities, and all other agencies providing ambulance services.
The policy covers both government and private ambulance service providers.

Core definitions for ambulance system

Ambulance means a vehicle designed and equipped for transporting sick or injured patients to, from, and between places of treatment by land, sea or air, affording safety and comfort and avoiding aggravation of illness or injury.
Ambulance Driver means a person who possesses a valid professional driver’s license, has undergone Basic Life Support Training, and has been issued an appropriate identification card by the DOH.
Ambulance Service means a vital health service for delivering pre and post hospital care from the incident site to the emergency room of the appropriate receiving hospital for definitive care, and for transfer to another hospital for further diagnostic and treatment.
Disaster means an actual threat to public health and safety where the local government and the emergency services cannot meet the immediate needs of the community.
Emergency means an actual threat to an individual’s life or to public health and safety requiring immediate response.
Medical Care Providers means doctors, nurses, and paramedical personnel from either government or private institutions who perform pre and post hospital care to sick and/or injured people resulting from an emergency or a disaster.

Mandatory ambulance use rules

Every emergency or disaster victim must be transported safely to and from the nearest appropriate hospital for definitive care.
The ambulance must be used to transport a patient, especially the critically ill/serious and/or injured.
The ambulance must also be used to transport medical care providers, and blood and emergency supplies.
No ambulance may be used for purposes other than those provided under the background and policy statements of this order.
No ambulance may be used to transport cadavers.
Patient safety and protection and the safety and protection of medical care providers must be given primary consideration.
All agencies providing ambulance services must comply with standards and guidelines of the Department of Health.
All hospitals are required to have ambulance services unless allowed by DOH regulations to contract out these services.
The ambulance must be properly marked and identified.

Ambulance service operational requirements

Ambulance services must have appropriately trained and competent personnel.
Ambulance services must provide appropriately staffed ambulances.
Ambulance services must have ambulances equipped according to the type, classification and level of hospital and ambulance service.
Ambulances must be regularly maintained.
Ambulances must always be properly cleaned, sanitized and decontaminated before and after transporting a patient and medical care providers.
Ambulance services of hospitals should preferably be under the direct supervision of the Emergency Department, with support from the hospital Administrative Department.

DOH standards, licensing, and identification

Standards and guidelines must be developed, coordinated, and disseminated by the DOH among agencies providing ambulance services.
Only licensed ambulance service providers may use the word AMBULANCE to appear on their ambulances.
Ambulance medical care providers and ambulance drivers should preferably be covered by appropriate additional insurance.

Implementation roles and coordination

The National Center for Health Facility Development must prepare the National Development Plan for Ambulance Service.
The National Center for Health Facility Development must develop policies, standards, and guidelines for mobilization, management and care of patients in ambulances, and safety and protection of medical care providers.
The National Center for Health Facility Development must establish standards for continuous quality improvement (CQI) of ambulance services.
The Bureau of Health Devices and Technology must establish standards and guidelines for ambulance design.
The Health Emergency Management Service must undertake capability building for medical care providers and ambulance drivers.
The Bureau of Health Facilities and Services must establish licensing standards for ambulance services and ensure implementation through regulation; the license of a hospital-based ambulance service must be part of the hospital license, and all other ambulance services must require a separate license.
The Centers for Health Development must monitor compliance of ambulance service providers with DOH policies, standards, and guidelines.

PhilHealth, transport agencies, and public bodies

The Philippine Health Insurance Corporation (PHIC) must develop a scheme to ensure ambulance service is part of PhilHealth reimbursable packages.
PHIC must require hospitals to comply with DOH CQI standards.
The Land Transportation Office must maintain an ambulance database in coordination with the DOH.
The Land Transportation Office must develop and implement a fast lane for registration of all ambulances.
The Land Transportation Office must assist in monitoring ambulance use.
The Toll Regulatory Board must designate an emergency lane for ambulances free of toll charge.
The Philippine Charity Sweepstakes Office must comply with DOH national policies, standards, and guidelines for ambulance design.
The Philippine Charity Sweepstakes Office must coordinate closely with the DOH on ambulance distribution and must observe DOH standard ambulance design when procuring ambulances.
The Philippine Charity Sweepstakes Office must release ambulances given to agencies and Local Government Units only after proper training of the assigned medical care providers and ambulance drivers.
The Bureau of Fire Protection must comply with DOH national policies, standards, and guidelines for ambulance use and services.
Private and public groups providing ambulance service must comply with DOH national policies, standards, and guidelines for ambulance use and services.
Local Government Units must comply with DOH national policies, standards, and guidelines and support corresponding standard operating procedures developed by local hospitals, pursuant to a Memorandum of Agreement between the DILG and the DOH.
Hospital associations and private hospital associations must support the type of ambulances recommended for specific hospitals and provide training and networking support.
The Philippine National Red Cross must comply with DOH national policies, standards, and guidelines; must develop corresponding standard operating procedures; must provide training for medical care providers and ambulance drivers; and must provide networking support to ambulance service providers.
The Philippine National Police (Highway Patrol Group) and the Metro Manila Development Authority must comply with DOH national policies, standards, and guidelines; must ensure traffic enforcers assist, direct, and provide clear roadways for ambulances; must assist in monitoring ambulance use; and must apprehend violators of proper ambulance use.
The Armed Forces of the Philippines must comply with DOH national policies, standards, and guidelines and must provide support for continuous ambulance operation needs from land to air or sea transfer.

Manuals and required standard operating procedures

The Undersecretary of Health for the Policy and Standards Development Team for Service Delivery of the DOH must organize and oversee technical working groups that prepare Manuals of Standards and Guidelines for Ambulance Design, Services and Training.
The DOH must prepare manuals in consultation with ambulance service providers, emergency medicine experts, and other stakeholders.
Implementing agencies must develop their own Standard Operating Procedures to fit their roles and responsibilities.

Repeal of inconsistent provisions

Provisions from previous issuances and other related orders that are inconsistent or contrary to this order are amended and modified accordingly.