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Plan needed for emergency ambulance services

While progress had been made in pre-hospital emergency care provision in Ireland, serious issues remained in the organisation of these services in the Dublin area, according to a report published on Friday by HIQA.

The review of progress made in implementing recommendations following HIQA’s review of pre-hospital emergency care services, found that overall, more needed to be done to ensure that a modern, effective emergency ambulance service was provided by Ireland’s two publicly funded services: the National Ambulance Service and Dublin Fire Brigade.

Sean Egan, HIQA’s Acting Head of Healthcare Regulation, said“Since 2014, a number of key improvements have occurred in the provision of pre-hospital emergency care services. In particular, the National Ambulance Service move to a single control centre over two sites has been a major enhancement in service provision. Furthermore, the National Ambulance Service now has a very clear understanding of what it needs to do to progress services and is better governed and supported by the HSE to progress this improvement. However, the National Ambulance Service still lacks necessary capacity and, despite increased recruitment rates, remains reliant on overtime to maintain services.”

A key finding of this Review related to the provision of services in Dublin. HIQA found a high level of risk associated with a lack of collective ambulance capacity and arrangements for call handling and dispatch.

Mr Egan said: “In Dublin, it was clear to the HIQA Review Team that significant shortcomings remain that put patients at risk. While lines of communication, formal governance arrangements and working relationship at senior management level within the HSE and Dublin City Council were much improved, a detailed plan for the delivery of emergency ambulance services in the greater Dublin area still does not exist.

“Furthermore, as things stand, if a patient with a potentially life threatening condition in Dublin calls 112/999 for an ambulance, current arrangements for call handling and dispatch can result in a delay in response due to the process for transferring calls from Dublin Fire Brigade to the National Ambulance Service. Alternatively, a Dublin Fire Brigade resource may continue to be dispatched to such a call in a situation where a nearer National Ambulance Service resource may have been available and better placed to respond.

“The status quo puts patients at risk and cannot be allowed to continue. It is, therefore, incumbent on those with overall governance responsibility for publicly-funded ambulance services in Ireland to ensure that there is a clear plan for the future of services in Dublin that is based on ensuring the safest and best possible service for patients.”