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Starting a Ambulance Service in South Africa

There's only three reasons why you would see this page, and that would be either you are considering starting a ambulance service, curiosity about the efforts going into starting a ambulance service or you are here to fact check me. Well, whatever the reason may be; here you go:

So, first of all, lets call it an Emergency Medical Service from now on and not a Ambulance Service. Starting a Emergency Medical Service is a costly endavour and can come with massive financial implications.

With the Department of Health's new (2017 new) Emergency Medical Service Regulations there are alot more to consider than just buying a vehicle, converting it and jumping in to save lives. Its not something impossible and it is entirely do-able even in a saturated area.

The first question is at what level of care do you want to operate. The two levels are:

  1. Intermediate Life Support (ILS) Service
  2. Advanced Life Support (ALS) Service

There are two additional categories that you can register in addition to one of the services levels above. You can register for one or both of them, or you can skip them entirly.

  1. Events Medical Service - Minimum ILS Service
  2. Aeromedical Service - Minimum ALS Service

Each of the level of care services there are multiple different requirements in order to even attempt to register as such a service. If you choose to register as a Intermediate Life Support Service you can at a later stage upgrade to a Advanced Life Support Service, but this entails re-registering at all the regulating bodies, so if I have any advise, start with a Advanced Life Support Service from the start.

Read more about the different service levels here: xxx

After you decided at which service level you are going to operate, the process can starts, but keep in mind, with each point listed below there are a number of requirements that have to be met:

  1. Register a Company at the CIPC, as well as SARS.
  2. Procure a Vehicle to be used as a ambulance and convert the vehicle, or buy one already converted.
  3. Employ medics; yes you heard right, but I will explain this a bit later.
  4. Sign various Service Level Agreement's with providers.
  5. Take insurance on vehicles, malpractice and public liability.
  6. Get a place to be base from.
  7. Apply at the Department of Health for a operating lisence.
  8. Wait anywhere from 1 month to 4 months for the application to be reviewed and approved, afterwich you will receive a temporary lisence, pending a physical inspection. And yes, the application can be rejected and you wasted all the money on vehicles, staff, equipment etc.
  9. While you wait you can start getting things ready like operational documentation, procuring consumables, uniforms, equipment, etc.
  10. With the temporary lisence you can apply at the Board of Healthcare Funders for a Practice Number to claim from medical aids, insurances etc.
  11. While you wait for your practice number from the BHF you are allowed to operate your emergency medical service, but.
    • I will advise at this stage to stick to private patients who will pay you directly as you are not allowed to bill any medical aid or medical insurance, etc.
    • You will only be allowed to bill these insitutions from the date that appears on your BHF Certificate and not a minute before that.
    • This also takes anywhere from 2 to 4 months.
  12. You finally received your Practice Number from BHF and you are ready to fully operate
  13. From here it is your decision wheter you want to apply at medical aid administrators to be a Service Provider so they can utilize you when they dont have a ambulance available, which I definately would suggest to do.
  14. You've completed your first PRF

This is really scratching the surface and below are links to additional information:

  • Emergency Medical Services Requirements:
  • Emergency Medical Services Advanced Life Support Requirements:
  • Emergency Medical Services Intermediate Life Support Requirements:
  • Emergency Medical Services Events Service Requirements:
  • Emergency Medical Services Aeromedical Requirements:
  • Emergency Medical Services Department of Health Application Requirements:
  • Emergency Medical Services Board of Healthcare Funders Application Requirements:
  • Emergency Medical Services Applying at Medical Aids and Institutions:
  • Emergency Medical Services Inspection Day:

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