NHAI Standardizes Ambulance Services Across EPC and HAM Projects

The National Highways Authority of India (NHAI), vide Policy Circular bearing reference no. 11.107/2026 and Policy Circular bearing reference no. 11.108/2026, both dated August 20, 2026 (collectively, the “Circulars”), has introduced amendments to the standard contractual frameworks for Engineering, Procurement and Construction (EPC) and Hybrid Annuity Model (HAM) projects, respectively, to standardise ambulance services on National Highways. The Circulars seek to ensure uniform ambulance deployment, technology-enabled monitoring, defined Service Level Agreements (SLAs) and Key Performance Indicators (KPIs), and effective consequences for non-performance. In the EPC Agreement, the amendments have been made to Schedule-C, Schedule-E and Schedule-M, while in the HAM, corresponding amendments have been made to Schedule-C and Schedule-K.

The Circulars provide for deployment of ambulances through a Centralised Ambulance Deployment Agency selected by NHAI, at a frequency of one ambulance per 50 km of Project Highway or part thereof, with the location determined by the NHAI based on site requirements. The Contractor and Concessionaire shall reimburse the expenses for such ambulances to the Centralised Agency and provide the requisite infrastructure for stationing the ambulance, including a parking shed, staff room, toilet, drinking water, lighting and electricity. These requirements are incorporated through the substituted Clause 14 (Emergency Medical Services) of Schedule-C (Project Facilities) in the EPC Agreement and Clause 14 of Schedule-C, read with Schedule-K (Maintenance Requirements), in the HAM Agreement.

The Circulars further integrate ambulance operations with NHAI’s Digital Incident Management System (“NHAI Care System”), requiring compliance with prescribed SLAs/KPIs throughout the relevant contractual period. In the EPC Agreement, these requirements have been incorporated under Schedule-E (Maintenance Requirements) for the purposes of Paragraph 1(i) of Schedule-M, while under HAM, the corresponding requirements have been incorporated in Schedule-K. The performance parameters include:

• usage of the NHAI Care Application by on-road units and incident managers, with more than 99% system availability required each day;
• availability of AIS-140-compliant GPS and continuous visibility of ambulances on the IMS care dashboard;
• timely acceptance of incident tickets and movement of ambulances;
• reaching the incident site within 10 minutes for incidents within a 10 km vicinity, with a proportionate increase for greater distances and the nearest hospital within 1 hour from ticket acceptance; and
• availability of requisite equipment, medicines and personnel, together with mandatory daily dry runs/mock drills involving travel of at least 5 km every 24 hours, subject to the specified exception where the ambulance has already travelled more than 5 km while attending an accident.

Under the EPC framework, non-compliance shall attract payment reductions from the Monthly Maintenance Payment under Paragraph 3 of Schedule-M, computed automatically through the NHAI Care System and effected by the Authority’s Engineer in the Monthly Maintenance Payment Statement; such reductions shall be in addition to those under Paragraph 2 of Schedule-M and shall be capped at INR 2.50 lakh per month per ambulance.

Under the HAM framework, the corresponding mechanism has been incorporated into Schedule-K (Maintenance Requirements), with non-compliance attracting monthly penalties similarly computed through the NHAI Care System and aggregated for deduction from the Biannual Maintenance Payments, subject to a maximum of INR 2.50 lakh per month per ambulance.

Any dispute regarding KPI/SLA compliance is to be decided by the Project Director concerned after examination of the relevant facts and evidence, without prejudice to the applicable dispute resolution provisions under the Agreement.

The Circulars also provide that an ambulance may be required to attend an accident outside the project jurisdiction, where the accident occurs on an adjacent National Highway project and an ambulance from that stretch is unavailable. This ensures that the ambulance network operates as an integrated emergency response mechanism rather than restricted strictly to individual project boundaries.