10.1
Avoiding road crashes and minimising their impact is typically the key goal of road safety initiatives. However, the reality is that crash injuries continue to occur. Accordingly, measures are needed to mitigate the consequences of crashes and enhance quality of life for those involved—to ensure crash-related injuries do not result in death or permanent impairment.
10.2
As outlined in Figure 10.1 below, effective post-crash response is complex, and often integrates emergency response, injury care, mental health, legal support and legislation, as well as data on crashes and injuries. Supporting first responders via training and support is critical, as is ensuring response efforts are underpinned by reliable data and sustainable investment.
10.3
This chapter considers evidence on post-crash response, with a focus on improving trauma care and mental health support; enhancing the timeliness and quality of post-crash response in regional and rural areas; improving post-crash responses via vehicle safety features; and supporting better health outcomes for Aboriginal and Torres Strait Islander peoples. The chapter also considers the extent to which post-crash response and care has been considered in road safety strategies, including the National Road Safety Strategy 2021–30 (NRSS 2021–30). It concludes with the committee’s views and recommendations.
Post-crash response in road safety strategies
10.4
Stakeholders indicated that post-crash response has not been given sufficient attention in road safety strategies, including the NRSS 2021–30. Accordingly, stakeholders called for crash response to be more thoroughly considered in the NRSS 2021–30 (and future strategies), noting that this will be critical to improving road safety outcomes.
10.5
The Australian Road Research Board (ARRB) noted that post-crash response has not been well addressed in road safety strategies, despite the importance of effective response having been recognised for decades.
10.6
In a submission on the consultation draft NRSS 2021–30, Roads Australia (RA) encouraged the Office of Road Safety (ORS) to include measures to improve post-crash response in regional and remote areas in the strategy, to deliver improved survivability.
10.7
By reference to Western Australia (WA), Injury Matters asserted that post-crash care should be incorporated into all guiding road safety documents, including strategies relating to road safety, freight transport, ambulances, and disaster management.
10.8
Engineers Australia (EA) noted that post-crash response is a multifaceted issue capturing actions taken by the first people to arrive on scene (often crash victims or observers rather than trained first responders) through to measures needed to rehabilitate the crash victim. According to EA, this broad conception of post-crash response is not accounted for in road safety strategies. EA called for a nationally consistent approach to post-crash response which captures all associated actors and processes.
10.9
State-based strategies give varied levels of attention to post-crash response as a means of addressing road trauma.
10.10
The New South Wales (NSW) Road Safety Strategy 2012–2021 states that safety outcomes may be significantly improved through coordination of emergency response and medical services, and by using technology to enhance response times, and proposes action for change.
10.11
The WA strategy, Driving Change, also recognises the importance of post-crash response to reducing road trauma. It proposes to focus on building the capacity of support services, technological solutions to enhance response capability, and gathering reliable data to build an understanding of post-crash response across the network.
10.12
By contrast, the South Australian (SA) Road Safety Strategy to 2031 and the Northern Territory (NT) Towards Zero Action Plan 2018–2022 appear to have a limited focus on post-crash response. Those strategies and plans appear to focus instead on the other four pillars of the Safe System.
Enhancing and maintaining the quality of post-crash care
10.13
Stakeholders indicated that while Australia has well-developed systems to support people impacted by road trauma, opportunities exist to improve these systems and—significantly—to ensure consistency in levels of post-crash care available across the country.
10.14
The Royal Australasian College of Surgeons (RACS) stated that Australia has some of the best post-crash trauma systems in the world, noting that Victoria showed ‘exemplary leadership’ when it established a trauma care system ‘effectively from 2000’ that integrates response efforts from the point of injury through to appropriate high-level care institutions. In addition, RACS stated that there is great value in mandatory and independent evaluation of trauma services. RACS noted that improved trauma response can reduce preventable fatalities by over 50 per cent, highlighting its ANZ Trauma Verification program as an example of good practice.
10.15
The Electric Vehicle Council (EVC) stated that training should be developed to support all people responding to trauma, including first responders.
10.16
The National Rural Health Alliance (NHRA) indicated that post-crash care in regional, rural, and remote areas could be improved by expanding the scope of practice for paramedics and health practitioners to include road trauma response. According to NHRA, this would help ensure sufficient health professionals are available to respond to a crash without impacting quality of care for the community more generally. Greater investment in the capacity of community-based paramedics and health services more generally could also drive improvements in these areas.
10.17
Access to data relating to post-crash outcomes, and enabling data linkages, were also highlighted as being key to improving road safety outcomes.
10.18
For example, Injury matters noted that there is currently no way of accurately quantifying the true impact of road trauma (including longer-term psychological effects and impacts on family, community members and first responders). Injury Matters stated that this is an area for further research, noting that gathering and linking the relevant data would require cross portfolio and intergovernmental cooperation. Inconsistencies in data (such different coding for injuries) may also create challenges.
10.19
RACS drew attention to the ANZ Trauma Registry (ATR), noting that the ATR is the only way to measure serious injury in Australia’s major trauma centres. RACS emphasised the importance of ongoing funding for the ATS to the evaluation and enhancement of trauma care outcomes.
10.20
ARRB observed that researchers have found it difficult to evaluate the quality of post-crash response due to a paucity of data. ARRB noted findings that there is no consistent method for collecting post-crash data, and that accordingly it is challenging to draw comparisons with other countries using available mechanisms.
Investing in mental health support
10.21
Injury Matters stated that research indicates between eight and 29 per cent of road crash survivors develop post-traumatic stress disorder (PTSD), and accordingly provision of high quality, accessible post-crash services is crucial. Injury Matters asserted that continued investment in post-crash care, and particularly mental health services, is a priority issue that requires further consideration at the national level.
10.22
Injury Matters also noted that mental health support for those impacted by road trauma (whether a person involved in a crash or a first responder) is inconsistent across jurisdictions. Injury Matters expressed support for a nationally consistent approach to mental health support associated with post-crash response but acknowledged that different community needs can make ‘one size fits all’ approaches unfeasible.
10.23
Injury Matters also called for implementation of a national post-crash referral pathway, noting that while the World Health Organization (WHO) describes mental health care as a core component of post-crash response, no clear referral pathway exists. Injury Matters told the committee that:
Following a serious road traffic incident there can be a variety of emergency, medical and financial professionals providing care to the individuals involved…[T]he development of automated referral pathways across a variety of government departments and agencies, including police, hospitals and insurance providers and the implementation of a system to enable the automatic referral of individuals to post-crash support services would be beneficial.
10.24
Injury Matters noted that more can be done to raise awareness of relevant services and to enable self-referral. Injury Matters indicated that it has developed useful resources (such as wallet-sized cards with relevant information), and that referral mechanisms exist in state trauma centres. However, additional investment could help to expand the reach of initiatives developed by Injury Matters and comparable organisations.
10.25
The Australasian Trauma Society (ATA) supported an increased focus on the psychological aspects of injury, noting that a lack of resources limits the ability of professionals to conduct research in this area.
Post-crash care for Aboriginal and Torres Strait Islander communities
10.26
Stakeholders indicated that more should be done to support post-crash response and care for Aboriginal and Torres Strait Islander communities, noting that communities have needs informed by the social determinants of health and that post-crash care for Aboriginal and Torres Strait Islander peoples must prioritise cultural safety.
10.27
The National Aboriginal Community Controlled Health Organisation (NACCHO) noted that Aboriginal Community Controlled Health Organisations (ACCHOs) provide vital post-accident care in regional, rural, and remote areas, and voiced concern that these organisations are frequently underfunded. Accordingly, the NACCHO called for increased funding for ACCHOs to deliver post-crash care, including for to training, medicines, and equipment.
10.28
NACCHO also highlighted the importance of ACCHOs having a majority of health practitioner who identify as Aboriginal and Torres Strait Islander, to facilitate trust and support cultural safety. Additionally, NACCHO called for the inclusion of post-crash response in training delivered by its affiliates to prospective health practitioners:
If there were a program, post-care help emergency would be a key element we want to include in training for Aboriginal health practitioners. There are so many accidents. It's not just Aboriginal people; there are tourists going through these places in their thousands. They must deal with them. They call in the Royal Flying Doctor Service if necessary. But that is a very helpful, good package to provide funding for training in emergency care and aftercare for all those regional and remote areas.
10.29
Dr Adam Heaton echoed many of NACCHO’s sentiments, raising concern that Aboriginal and Torres Strait Islander peoples are significantly under-represented in the health workforce and that this can limit access to services for Aboriginal and Torres Strait Islander peoples. According to Dr Heaton, employment of more Aboriginal and Torres Strait Islander peoples in ACCHOs would assist the provision of culturally appropriate healthcare as well as in the delivery of preventative health messaging around safe driving. Dr Heaton recommended investment in ACCHOs to deliver post-crash and trauma care, including training, medicines, and equipment, adding that all health services must ensure ongoing cultural competence through training and development, and through effective managerial oversight.
10.30
Injury Matters noted that road safety-related initiatives for Aboriginal and Torres Strait Islander communities often focus on preventing or mitigating the impacts of crashes (for example, through vehicle safety features or education and training), noting that while these programs are important, post-crash care could also be improved. Injury Matters also outlined how Aboriginal and Torres Strait Islander peoples generally access its services:
Access…ultimately depend[s] on the type of therapeutic response that somebody want[s] and whether they want a more formalised response. We…have more Aboriginal and Torres Strait Islander people that access the support elements of our service. When we say 'support elements' we mean that we do check-in phone calls that are seeing how somebody is tracking. If they've identified that they don't want to see a counsellor yet because they don't feel that they quite need it, we will continue to check in with them, with their permission, just to see how they're travelling. We tend to see more Aboriginal and Torres Strait Islander people[s] being open to that approach.
Improving emergency response in regional, rural, and remote areas
10.31
Stakeholders stressed that the time taken to respond to a road crash is a key determinant of survivability. Accordingly, stakeholders expressed concern that response times are long—particularly in regional and remote areas where access to medical services is limited.
10.32
ARRB noted that in rural and remote Australia, there are challenges associated with volunteer ambulance and fire crews travelling lengthy distances to reach the nearest trauma centre. In this respect, ARRB observed that small delays associated with call centres, delays in response times, cumbersome extrications, and long trips to trauma centres, can result in preventable deaths, particularly in the very remote regions of the country.
10.33
RA agreed that there is a need in regional and remote areas to improve crash response times, given that quick, responsive first on scene can save lives.
10.34
The Western Roads Federation (WRF) also highlighted that—regardless of the efficiency of contacting emergency services—in remote Australia there will inevitably be a prolonged wait time for first responders and that this will adversely affect survivability for a person involved in an incident.
10.35
NRHA highlighted similar concerns with response times. To address these issues, NRHA called for:
Employment of ambulance workers and paramedics closer to identified black sports, including via outreach models.
Surveillance monitoring of higher risk roads by emergency workers, to enable the most rapid response to emergencies.
Improved hospital staffing arrangements, to ensure the need to respond to a crash does not cause staff shortages across other divisions of care.
A well-developed emergency air and road transport system, especially for cases where it is necessary to bypass smaller regional hospitals for larger metropolitan services to avoid serious or fatal injury.
10.36
NRHA pointed to SA’s Rural Emergency Responders Network (RERN) as an example of effective, community-led emergency response, indicating that elements of that initiative should be adopted in other jurisdictions. NRHA explained that RERN:
…is a specially trained network of rural general practitioners who attend life-threatening incidents in rural parts of the state, including serious road injuries. In partnership with the South Australian Ambulance Service and retrieval services, they provide advanced clinical support for trauma patients. This is an example of the way in which services can be effectively provided to address road events as soon as possible after they occur, and it has been recommended that this model be rolled out on a national scale.
10.37
ARRB observed that a potential means of addressing the paucity of services in rural and remote areas (and consequent response delays) would be to train community members to assist at crash sites. ARRB noted that community members would not replace professionals but may be able to deliver preliminary first aid, assist professionals to locate crash sites, and assist in patient handover processes—helping to reduce error.
Improving post-crash response through vehicle features
10.38
Some stakeholders indicated that there are opportunities to improve post-crash response by fitting vehicles with features which automatically notify emergency services when an incident occurs, or which provide emergency services with additional information.
10.39
The Australasian New Car Assessment Program (ANCAP) noted that Europe has mandated e-Call systems in all new vehicles since April 2018. The Euro NCAP e-Call (adopted from UN Regulation 144) is as follows:
[I]n the event of a ‘triggering signal’ (such as an airbag deployment), [the] e-Call system will establish a voice connection with a [Public/private Safety Answering Point] and send a minimum set of data (MSD). The MSD includes: a time stamp of the generation of data; position [of the vehicle] determined by GPS signal; vehicle direction of travel; [and vehicle details including vehicle type and [fuel used].
10.40
According to ANCAP, while Australia does not require vehicles to be fitted with e-Call systems, the NRSS 2021–30 and associated Action Plans propose to consider whether e-Call systems should be mandated for new light vehicles. Noting that Australia is looking to evaluate emergency call features in its protocols, ANCAP called for e-Call to be prioritised in the development of triple zero services to be implemented by 2025 and for government to undertake regulatory processes to mandate fitment of e-Call, with an introduction no later than 2025.
10.41
ARRB noted that uptake of e-Call will ensure crashes—particularly single-vehicle crashes in regional and remote areas—will have the best possible chance of a rapid response, thereby decreasing chances a crash will result in death or lifelong impairment. ARRB added that Europe has made e-Call systems mandatory for new cars and light vans, with the system predicted to prevent 2,500 deaths and save $49 billion per year.
10.42
Stakeholders also highlighted potential challenges with e-Call systems, mostly linked to telecommunications network coverage. For example, WRF noted that if the e-Call system relies on the mobile network, large mobile phone black spots will create barriers to ensuring systems operate in remote areas. WRF said that there would be merit in exploring other options, including connecting by satellite phone via the Iridium network.
10.43
The Australasian College of Road Safety (ACRS) similarly noted that improved telecommunications networks are required for post-crash care, especially in rural and remote areas without access to mobile phone coverage or public telephones.
10.44
Rescue sheets were also highlighted as a useful means of enhancing post-crash response by providing information on a vehicle to first responders—to cut down the length of extrication and avoid potential risks.
10.45
ANCAP noted that its new tests for vehicle safety examine whether a vehicle is equipped with:
Standardised rescue sheets to assist emergency services.
Multi-collision braking—that is, brakes which engage after a collision occurs, to minimise the risk of a second crash.
10.46
ANCAP stated that its protocols for all new vehicle models rated to 2020 or later are required to provide a rescue sheet with applicable standards. Rescue sheets have also been retrospectively sought for a range of current and older vehicle models where available.
10.47
ANCAP added that it had created and launched an application—ANCAP RESCUE—to support post-crash response. According to ANCAP, the application contains standardised vehicle safety information for more than 1,162 vehicle models in the form of .pdf rescue sheets which highlight the location of potential in-vehicle hazards such as fuel tanks, high voltage batteries airbag inflators and high-strength steel.
Support for first responders
10.48
Several stakeholders emphasised that road crashes have a very significant traumatic impact on first responders (for example, police, paramedics, and emergency services personnel). The Police Federation of Australia (PFA) drew attention to a recent survey of over 21,000 fire, police, ambulance, and emergency services workers and volunteers—including former personnel. According to PFA:
One in three respondents reported experiencing high or very high psychological distress, compared to one in eight in the general population.
One in 2.5 respondents (one in three for volunteers) had been diagnosed with a mental health condition in their life, compared to one in five adults in the general population.
Respondents reported suicidal thoughts at twice the rate of the general population and were three times more likely to have a suicide plan.
Over half the respondents had experienced a traumatic event during their work that deeply affected them.
Respondents who had worked over ten years in police and emergency services are almost twice as likely to experience psychological distress and six times more likely to have symptoms of PTSD compared to those with less than two years’ service.
Three in four respondents who made a claim for psychological injury found compensation processes to be detrimental to their recovery.
10.49
PFA stated that there is ‘no doubt’ that psychological trauma to which emergency workers and police are exposed is due to attendance at vehicle crashes and—for police—being required to inform families that a death or serious injury has occurred.
10.50
Stakeholders asserted that more could be done both to raise the capacity of first responders to operate effectively during an incident, and to ensure responders can access adequate post-incident support such as counselling, peer support or workplace arrangements, to limit excessive exposure to traumatic circumstances.
10.51
As to enhancing the preparedness of responders, WRF indicated support for measures to enable paramedics and other first responders to remain calm at incidents—noting that police-type training may be useful. WRF stated:
It's one thing to give somebody a tourniquet; it's another thing to go the reality…[The] Queensland police…had an incident where [they and] a paramedic, had come across an accident where the dash had crashed down on the person's leg and the leg had severed. The paramedic couldn't deal with it…whereas the police have been trained in doing it. Because these things look realistic in their training, they were more able to cope. The words they used were, 'I've kind of seen it before; I kind of knew how to deal with it.' It's that combination.
10.52
PFA noted that many support mechanisms available to officers rely on self-reporting and oversight by senior staff. However, PFA also acknowledged there are programs in place to directly support police officers to manage their trauma, and that some are funded by the Commonwealth.
10.53
PFA also stated that work is needed to ensure police officers can access effective support services and to understand the true impact of road trauma on the police service—noting that data held by police forces is insufficient to measure the impact of trauma over an officer’s career. PFA also expressed interest in a program of the Department of Veterans’ Affairs that provides funding for psychiatric-trained assistance dogs to support veterans on the advice of medical experts, stating that:
Anything that limits symptoms of post-traumatic stress disorder, anxiety, depression, or any mental illness is welcomed…We want to ensure that we have people who are happy in their employment and who are resilient, who can go to those horrific motor vehicle accidents, realise that is acutely traumatic for them, deal with it, have proper psychological assistance and then, in time—maybe the next day or a couple of days after—go back to work and have a long and healthy career.
10.54
BRAKE drew upon experiences in the Australian Capital Territory (ACT) and Queensland police forces to highlight the value of peer-based support, stating:
The Queensland Police have a lot of support available. It starts at the police station level. We have…peer support officers who are colleagues that are there for that sort of thing. As a supervisor, a sergeant, we do that. The OCs do that. It's a different police service to the one we were years ago when I first started policing. We didn't have any of that.
10.55
The Australasian Fire and Emergency Service Authorities Council (AFESAC) noted that emergency response agencies routinely respond to road crashes by providing extrication and life support. According to AFESAC, there are opportunities to address the physical and mental impacts of road trauma, particularly for emergency service personnel who respond to incidents.
Heavy vehicle drivers acting as first responders
10.56
Stakeholders noted that heavy vehicle drivers (particularly truck drivers) are often obliged to act as first responders in some capacity—simply on the basis that they are first on scene. However, drivers are not adequately supported to respond to a crash—either in terms of training and expertise or post-crash debriefing and care. In this respect, WRF observed that:
Truck driver[s] [may have to] provide first aid response, care for the scene, care for [any] children. There are no other people…in remote areas. You would be lucky if there's another car every hour or every two hours...The other key point is…when the professional first responders arrive, we pat the truck driver on the back and say 'Hey, great job—off you go.'
10.57
WRF noted that in a survey of truck drivers, 75 per cent of respondents reported having been a first responder for over 30 minutes, with 30 per cent having been a first responder more than three times during their career.
10.58
WRF recommended that consideration be given to providing first responder training to truck drivers and frequent travellers in remote areas, noting that funded trials of such an initiative were conducted in the NT and WA with participants reporting high levels of satisfaction. WRF indicated that this initiative could be rolled out on a broader basis, noting that this will require measures to identify suitable drivers to act as responders and campaigns to raise awareness around the contributions trained drivers can make to post-crash response.
10.59
WRF indicated that training should allow drivers to imagine and mentally prepare for the circumstances of a crash, noting that there would be merit in involving defence force personnel in training processes. To sufficient drivers access the training, WRF noted that contractors or fleet managers could require drivers to undertake training as a condition of engagement.
10.60
Finally, WRF noted that while training would not be prohibitively costly, Commonwealth funding may be necessary to ensure that training can be rolled out nationally, and that training could be delivered by existing local providers following ‘train the trainer’ sessions.
10.61
The NT Department of Infrastructure, Planning, and Logistics (DIPL) also supported first responder training for heavy vehicle drivers—stating that training would be supported by the NT Road Transport Association. DIPL stated that road operations staff in the NT government are provided with first responder training as they are often first on scene for crashes. The training is included in employee development programs and can be implemented at minimal cost.
10.62
Other inquiry participants expressed support for more general first aid training and mental health services for heavy vehicle drivers.
10.63
The Toll Group advocated for the addition of first aid competencies to the heavy vehicle licensing framework. Toll also indicated that as heavy vehicle drivers often act as first responders in any case, there should be a greater focus on ensuring drivers have access to mental health services.
10.64
Encouraging heavy vehicle drivers to provide information on the location of a road crash (irrespective of whether they provide other assistance) was also raised. In this respect, WRF noted that since truck drivers carry satellite phones, use GPS tracking, and are connected through the Iridium satellite network, they are unlikely to be affected by gaps in coverage and can help pinpoint sites for professional responders. WRF told the committee that:
A lot of trucks carry sat phones, which is good, but not all of them. A lot of the trucks increasingly now are mobile tracked. One of the [key] issues in remote areas is to identify where you are…There's an option on the trucks to have a backward messaging service. They can hit an alert which backward messages through their GPS tracking sensor to advise back to base that there has been an incident, which will notify both that there's an incident and, more importantly, exactly where it is.
Reporting of road crashes in the media
10.65
Some stakeholders noted that although media coverage of crashes can be useful—particularly in terms of raising awareness of road trauma—certain approaches can lead to adverse outcomes and may increase the trauma experienced by those who have been impacted by the event. Stakeholders called for greater sensitivity in how crashes are reported, with coverage informed by appropriate guidance material.
10.66
Injury Matters observed that studies have found the national Mindframe guidelines to be effective in improving the nature and quality of mental health reporting across all media formats. Accordingly, Injury Matters called for the development of similar (mandatory) standards for reporting of road trauma, including information for consumers on available support services.
10.67
Injury Matters expanded on this issue during one of the committee’s public hearings, noting that:
Clients often discover that a loved one has sustained a fatal or serious injury via news reporting before police notification has occurred.
Media organisations may focus on the ‘salacious’ side of road trauma. For example, reporting may focus on a person who has caused a road accident being paroled from prison and accompany a story with images of those impacted by the event and opinions about the parole decision.
Media organisations may use a ‘sensationalised’ style of reporting.
Committee view
Enhancing post-crash response and care
10.68
The committee heard that Australia has well-developed systems in place to enable effective post-crash responses and trauma care, with some systems recognised as examples of leading practice at the international level. However, stakeholders indicated that many systems are confined to specific states, and there are opportunities to improve post-crash response systems across the country—including by building the capacity of health services and practitioners and enabling consistency across jurisdictions in how post-crash care is delivered.
10.69
The committee also heard that reliable and accurate data will be crucial to enhanced post-crash responses, with stakeholders noting a paucity of data on crash response and trauma care outcomes as well as underdeveloped mechanisms to link data from different sources.
10.70
The committee heard that there is a particular need to invest in effective mental health support, both for those directly involved in a crash (such as passengers or vulnerable road users) and those impacted by road trauma in other ways (such as first responders, families and communities). Stakeholders called for investment in mental health services to remain a priority at the national and state levels and called for the development of a nationally consistent approach to mental health support linked to road trauma. The committee heard that this should involve improving referral processes and providing more information on the availability of services.
Improving post-crash care for Aboriginal and Torres Strait Islander communities
10.71
Aboriginal Community-Controlled Health Organisations (ACCHOs) were highlighted as being best-placed to deliver post-crash care to Aboriginal and Torres Strait Islander peoples, as these services employ high numbers of Aboriginal and Torres Strait Islander practitioners and deliver supports via a framework that ensures culturally appropriate care. In addition, ACCHOs are well-placed in regional and remote communities to deliver care and support for people who do not identify as Aboriginal and Torres Strait Islander, including tourists and other visitors.
10.72
The committee heard that, notwithstanding the clear value of ACCHOs to effective post-crash care, ACCHOs are often underfunded. Accordingly, stakeholders called for additional investment in ACCHOs, including for training, staffing resources, medicines, and equipment. Stakeholders also called for additional funding to support additional training in post-crash care to health practitioners.
Improving response times
10.73
The committee heard that the response times associated with road crashes (including responding to calls, travel to a scene, and transport to hospital) are key to survivability for those involved. The committee was therefore concerned to hear that response times are often lengthy—particularly in regional and remote areas where access to medical services is limited.
10.74
Stakeholders suggested solutions to this issue, including the engagement of emergency services and healthcare workers close to higher-risk areas; closer monitoring of roads to enable faster responses; enhancing hospital staffing arrangements; and investing in an effective emergency air and transport system. Stakeholders also noted that there may be merit in training and building the capacity of community members to undertake preliminary emergency response activities, to enable more timely response and alleviate the burden imposed on emergency and healthcare services.
Improving post-crash response through vehicle safety features
10.75
The committee heard that there are opportunities to improve post-crash response via vehicle safety features. Stakeholders noted that such features can increase the timeliness of responses by pinpointing the location of a crash (e-Call systems) and by providing information to emergency service personnel about the vehicle—helping to facilitate extrication and reducing risks associated with in-vehicle hazards.
10.76
The committee heard the NRSS 2021–30 proposes to consider mandatory fitment of e-Call systems. Stakeholders supported this proposal and called for e-Call to be prioritised in the development of new triple zero services to be implemented by 2025. In this respect, stakeholders noted that there may be challenges to the use of e-Call associated with telecommunications infrastructure which will need to be overcome.
Supporting first responders
10.77
The committee heard that road trauma has a very pronounced effect on first responders such as paramedics, police, fire, and emergency service workers and volunteers. This was highlighted in a recent survey of first responders with a large subject pool. Noting the significant psychological impacts on first responders, stakeholders asserted that more must be done to build the capacity of first responders and to ensure they have access to adequate supports. Stakeholders gave suggestions for additional training (including police-type training to prepare first responders for the trauma which will be encountered) and called for support mechanisms to be embedded in relevant organisations—underpinned by sustainable investment.
Post-crash response in the National Road Safety Strategy 2021–2030
10.78
The committee heard that post-crash response and care has not been given sufficient attention in the NRSS 2021–30 or in road safety strategies at the state level. On reviewing the NRSS 2021–30, the committee notes that while the strategy supports capability-building for trauma care workers, it does not appear to propose specific measures in this regard. Moreover, the strategy does not appear to propose actions for enhancing trauma care generally, enabling better, more rapid post-crash responses, or ensuring first responders have access to mental health supports. The strategy includes a priority focused on the needs of Aboriginal and Torres Strait Islander peoples. However, this appears to be concerned with preventing or mitigating the impacts of road crashes.
10.79
Noting the apparent limitations in the NRSS 2021–30 regarding post-crash response (including as raised by stakeholders), the committee considers that the Commonwealth should include in the strategy a priority focused on post-crash response accompanied by proposals for action. These proposals should capture capacity-building for trauma support services, gathering data on the effectiveness of post-crash response, improving psychological support for to crash victims, first responders and others impacted by road trauma; supporting post-crash response for Aboriginal and Torres Strait Islander people and communities; improving post-crash response via vehicle safety features; and ensuring crashes are reported in a sensitive way.
10.80
The committee recommends that the Australian Government amend the National Road Safety Strategy 2021–2030 to include a priority area focused on improving and delivering national consistency in post-crash response and care. This should be accompanied by actions focused on:
Building the capacity of trauma services.
Increasing the availability of mental health support.
Obtaining reliable, accurate data on post-crash response, and improving data linkage efforts.
Supporting and building the capacity of first responders.
Improving the quality and timeliness of post-crash responses in regional, rural, and remote areas.
Supporting post-crash care outcomes for Aboriginal and Torres Strait Islander peoples and communities, including increasing investment in Aboriginal Community-Controlled Health Organisations.
Appropriate reporting of road trauma in the media.
Heavy vehicle drivers acting as first responders
10.81
The committee heard that there is support for additional, more specialised training for the heavy vehicle sector on post-crash response. Stakeholders noted that heavy vehicle drivers are often obliged to act as first responders, and that drivers are not adequately supported to respond in terms of expertise or post-crash debriefing and care.
10.82
The committee heard that trials of post-crash response training for heavy vehicle drivers have been conducted, with programs leveraging techniques used by police and defence personnel to prepare drivers to encounter and respond to road trauma. Participants reported high levels of satisfaction.
10.83
The committee heard that post-crash response training for the heavy vehicle sector could be rolled out nationally at relatively low cost. Suitable drivers will need to be identified to participate in the training, and there will need to be measures to embed training in organisations, raise awareness about the contribution of heavy vehicle drivers to post-crash response, and ensure that mental health supports are available to drivers after an incident occurs.
10.84
The committee sees real merit in the training program and considers the Commonwealth should investigate measures—including investment—to support national rollout. Noting the recommendation above that post-crash care should be included as a priority in the NRSS 2021–30, the committee is of the view that training for heavy vehicle drivers should be included in the strategy as an action item.
10.85
The committee recommends that the Australian Government work with state and territory governments, the heavy vehicle sector, and other road safety stakeholders to support national rollout of first response training for heavy vehicle drivers. The committee considers that this training should be included as an action item in the National Road Safety Strategy 2021–2030.