KEY FINDINGS FROM THE REVIEW INTO VICTORIA'S EMERGENCY SERVICES TELECOMMUNICATIONS AUTHORITY (ESTA):

* From January 2016 to November 2020, ESTA met and often exceeded its benchmark of answering 90 per cent of emergency ambulance calls within five seconds.

* ESTA did not meet its benchmark in any month from December 2020 to June 2022.

* From July 2021 to May 2022, ESTA reported 40 potential adverse events associated with call answer delays or other issues. In these events, 33 patients did not survive their emergency.

* ESTA processed 53,201 more emergency ambulance calls in 2020-21 than the previous year (6.4 per cent increase).

* There was a clear surge of emergency ambulance calls from October 2021, with ESTA processing 991,146 calls in 2021-22 (a 12 per cent increase on the previous year).

* Some callers to triple zero who waited more than 75 seconds for ESTA to answer did not get answered in the expected order of first come, first served.

* Increases in emergency calls strongly correlated with COVID-19 infections, with more patients presenting with breathing problems and chest pains in 2021 (increase of 24.9 per cent and 21.3 per cent respectively on 2020 numbers).

* ESTA's existing fee and funding model is insufficient and does not provide adequate funding to cover its costs. The Victorian government was aware of ESTA's precarious financial position as early as 2015.

RECOMMENDATIONS FROM THE REVIEW INTO ESTA:

* The Victorian government should advocate to the federal government for changes to the national triple-zero call answer policies, including revisions to minimise the chance of callers losing their place in the call priority queue.

* ESTA needs to publicly report its progress in improving its resourcing and management of surge events through its annual reports and corporate plan.

* The Department of Health should enhance existing governance arrangements to ensure a whole-of-system approach to pre-hospital services for a health emergency, in both an everyday and surge context.

* The department should ensure an appropriate mix of output and outcome measures are developed for all service types (ie. ambulance, police, and fire services).

* The department should better integrate ESTA into the State Health Emergency Response Plan and ensure its functions are fully considered in pre-hospital arrangements.

* The government should clarify overall policy responsibility for demand management of triple-zero calls by service type and conduct further research into effective triple-zero community messaging.

* ESTA should conduct research into optimal shift patterns and rostering arrangements for staff.

* ESTA should review its extreme event automated voice messages and ensure there are appropriate scripts for unknown emergencies.