New ambulance review finds current response time target is not achievable

The report found Irish ambulances have more rural callouts than UK counterparts

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An ambulance service capacity review has found Irish ambulances serve a much greater rural population than their counterparts in England and Scotland.

The report, commissioned by the Health Service Executive (HSE) and carried out by Lightfoot Solutions UK, says this "presents major challenges for performance when directly compared with same response time standards in the United Kingdom".

It says in Ireland, 40% of incidents are in a rural location, compared to 12% in a typical UK service.

"It is much more difficult to achieve response time targets for calls in rural areas than urban areas because of the longer distance to drive. It also noted that there are 40% less calls per head of population within Ireland compared with the UK".

One of the key findings of this report was that it is not possible for the National Ambulance Service to achieve the current 80% response time target.

The HSE national director Mr Damien McCallion said: "It does recommend the development of a new way of measuring our pre hospital emergency care services that incorporates response times, patient outcomes and patient satisfaction with the service".

"Other countries such as Wales have already moved in this direction which places greater emphasis on outcomes for patients".

These response time targets only relate to calls that categorised as potentially life-threatening calls.

"A clear direction"

According to Martin Dunne, director of the HSE National Ambulance Service: "In comparing our service with those in the UK, Lightfoot have provided us with a clear direction for what needs to be done to enhance our service over the next seven years".

"The recommendations, once implemented will improve pre hospital emergency care services for our patients and this in turn will have a positive impact on the wider health services".

The report recommends a new model for pre-hospital emergency care services - with patients given increased care choices which, in many instances, may not require a visit to the Emergency Department.

This will include a range of improvements in the HSE National Emergency Operations Centre, including the establishment of a clinical support desk to offer improved medical advice and services to patients.

It also recommends an improved model for rural and remote locations with an extensive rollout of Community First Responder Schemes, co-locations of paramedics with primary care professionals and continued use of aeromedical services.

While the report has seventeen recommendations, these can be grouped into four main areas:

  • Improved operational processes through further investment in ambulance and related vehicles and control room technology
  • Introduction of dynamic deployment of ambulances to reduce the distances required for emergency response vehicles to respond (where ambulances are not maintained at specified static bases but used in a more flexible manner that reflects the population needs)
  • Introduction of additional resources in prioritised locations
  • Expansion of the number and scope of practice of Community First Responder Schemes

The HSE has developed an action plan, which it says will allow for the implementation of the recommendations of both this review and the 2014 HIQA report.

View the full report here