Stretched ambulance services leaving patients at risk

A HIQA report has found a “high level of risk” to patient safety due to a lack of capacity and call and dispatch arrangements

The government’s health watchdog has warned that a lack of adequate ambulance cover in Dublin is putting patients at risk and “cannot be allowed to continue.”

The Health Information and Quality Authority (HIQA) has found a “high level of risk” to patient safety related to a lack of ambulance capacity in the city and the arrangements for call handling and dispatch.

Ambulance dispatch in Dublin is currently shared between the dispatch centres for the National Ambulance Service (NAS) and Dublin Fire Brigade (DFB).

Ambulance delays

Sean Egan, HIQA’s acting head of healthcare regulation said the system can result in delays due to the process of transferring calls from the fire brigade to the ambulance service.

He said the system can also lead to fire brigade services being sent to a call when a NAS vehicle is available and “better placed to respond.”

“In Dublin, it was clear to the HIQA Review Team that significant shortcomings remain that put patients at risk,” said Mr Egan warning that “a detailed plan for the delivery of emergency ambulance services in the greater Dublin area still does not exist.”

He called on Dublin City Council to put in place a clear plan for the future of Dublin’s ambulances services that is “based on ensuring the safest and best possible service for patients.”

“The status quo puts patients at risk and cannot be allowed to continue,” he said.

Plans to remove call and dispatch functions from Dublin Fire Brigade and merge them with the HSE Ambulance Service nearly led to industrial action at the fire brigade earlier this month.

Unions said the outsourcing of the call and dispatch service could be the first step towards dismantling the fire brigade’s Emergency Medical Service.

The two days of industrial action were postponed last week in order after the two unions representing fire officers agreed to enter talks with Dublin City Council.

National service

The HIQA report, entitled ‘Review of progress made in implementing recommendations following HIQA’s review of pre-hospital emergency care services’ also found that on a national level, the ambulance service “still lacks necessary capacity.”

It found that despite an increase in recruitment the NAS “remains reliant on overtime to maintain services.”

The report found that moving the NAS to a single control centre over two sites has been a major enhancement in service provision adding that it is now “better governed and supported by the HSE to progress this improvement.”

Overall, HIQA found that more needs to be done to ensure that a modern, effective emergency ambulance service is provided by Ireland’s two publicly funded services.