The procedures for the reform of urgent and pre-hospital care in Cyprus are in full swing with time running out and the timetable for the completion of the preparation set for next November.
The Ministry of Health, the State Health Services Organization, the ambulance service and other involved state services and departments have now entered a race to catch up with the procedures both for the operation of the National Ambulance Agency in general and the transport of ambulances to it, as well as for the creation of the Poison Control Center, which will operate for the first time on an organized basis in Cyprus.
The complex project includes, among other things, the transfer of personnel, vehicles and equipment from OKYPY to the National Agency, the transfer of contracts and the settlement of the financial claims of OKYPY, while during yesterday's meeting at the Ministry of Health, the responsibilities were determined and instructions were given in order for everything to be ready on January 1, 2027 as provided for by the relevant legislation.
As far as the creation of the poison center is concerned, the procedures for its staffing and equipment are already underway.
As defined by law, it will cover the whole of Cyprus and will operate on a round-the-clock basis providing free information and instructions to doctors, other health professionals, Accident and Emergency Departments, hospitals and ordinary citizens to manage poisoning incidents.
Its operation, of course, is expected to fill the significant gap that exists in Cyprus in terms of dealing with poisoning from medicines, chemicals, agricultural preparations, household products (cleaners), plants, mushrooms, poisonous animals and other factors.
Specifically, and through direct telephone guidance, the risk can be assessed according to each case and instructions will be given for the first measures, the need to send an ambulance or the transfer of the person in danger to an A&E.
In order for it to operate properly and safely, the center must have the necessary staffing with properly trained staff, ensure scientific supervision, access to specialized toxicological databases, prepare cooperation protocols with hospitals and laboratories and technically interconnect with the emergency management system.
Interest from private companies in simple transfers
In the context of the upcoming operation of the National Ambulance Agency, interest has begun to be expressed by the private sector as, as we are informed, ambulance service companies have already contacted the Ministry of Health, asking for information on the application process and securing the required license.
The licensing process has been defined and is based on the provisions of the new legislation, which creates a Register of Registered Ambulance Service Providers and Registered Ambulance Vehicles.
The plan envisages that licensed private companies will be able to undertake mainly the simple, scheduled patient transports. These include, among other things, movements to and from the home, hospitals, diagnostic centers, rehabilitation units, rooftops and palliative care centers, when the patient does not need urgent pre-hospital intervention.
The aim is to separate in practice simple transfers from real emergencies.
After the start of the implementation of the new framework, all ambulances operating in the private sector and serving the needs of private hospitals will go through checks and inspections. The suitability and condition of the vehicles, the equipment available, the category in which they can be included, the composition of the crews, the certifications of the personnel and the insurance coverage will be examined.
Agreements and pending issues for the transport of ambulances
According to information, at yesterday's meeting at the Ministry of Health, the responsibilities were distributed among those involved, with each service undertaking a specific part of the reform and being called upon to complete it, based on a separate timetable, certainly before November.
The timely completion of the procedures is considered necessary in order to have the required time for the last audits and administrative arrangements before the official operation of the Agency on December 31, 2026.
One of the most important and complex issues concerns the transfer of personnel. Today the ambulance service is staffed by people with different service statuses, which requires different handling.
For the civil servants who currently serve in OKYPY on secondment, the procedure provides for the end of their secondment and their return to the Ministry of Health. At the same time, employees who are employed under an OKYPY contract should be transferred to the new Body with the procedures provided by law. The same will apply to hourly paid staff.
A parallel process is underway for the transport of ambulances, other vehicles, medical equipment and materials currently used by the ambulance service.
The legislation provides that OKYPY will provide the National Agency with the equipment, materials and vehicles it owns and an agreement must be concluded between the Ministry of Health and OKYPY for their transport, while the Organization will be compensated from the state budget.
In the context of the discussions, as we are informed, it seems that the possibility of OKYPY retaining some vehicles is being considered, as it intends to continue to carry out simple or scheduled patient transports.
No final decision has been taken or, at the very least, no official position has been formally expressed on the matter.
The accreditation secured by the ambulance service during its operation under OKYPY is also pending. The question under consideration is whether this accreditation can legally follow the ambulance service at the Ministry of Health or whether a new evaluation process will be needed.
Contracts with HIOs, CUT and other bodies
Also important is the issue concerning the contracts currently maintained by OKYPY on behalf of the Ambulance Service, such as, for example, the agreements with the Health Insurance Organization, but also with other bodies, such as the Cyprus University of Technology for the IT system.
In order to transpose these contracts, it is necessary to consider whether there are legal obstacles that must be overcome.
The compensation that OKYPY will request
The financial part also remains open. OKYPY claims that in the last six years it has allocated significant funds to strengthen the ambulance service and, therefore, must be compensated for the property and investments that will be transferred to the new National Ambulance Agency.
The costing is expected to be completed in the autumn and, in any case, before the November deadline. Then it must be agreed which data will be transferred, with what valuation and what amount will be paid to OKYPY from the state budget.
It is stated that even after the operation of the National Agency, the current hierarchy of the ambulance service will be maintained.
