National Ambulance Service Baseline and Capacity Review

The HSE has today, Wednesday 18th May, published the report of the National Ambulance Service of Ireland, Emergency Service Baseline and Capacity Review.   

Commissioned by the HSE and carried out by Lightfoot Solutions UK Ltd (who have extensive experience in supporting British and Irish ambulance services) the report determines the ambulance service capacity requirements in order to deliver the HIQA response times targets for pre hospital emergency care in Ireland, as set out in the HIQA Report (2011).

Lightfoot found that the Irish ambulance services serve a much greater rural population than their counterparts in England and Scotland. This presents major challenges for performance when directly compared with same response time standards in the United Kingdom.  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.

Although stressing that 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 (which was also highlighted in the 2014 HIQA report),  HSE National Director Mr Damien McCallion said that “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. ”

According to Mr Martin Dunne, Director of the HSE National Ambulance Service:   “This review is the first of its kind to be conducted in Ireland. 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.  It has identified a significant need for investment in staff, technology and in community engagement to improve the service.”

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 the aeromedical services.

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

  • 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 on the number of Community First Responder Schemes

The HSE has developed an Action Plan which will allow for the implementation of the recommendations of both this review and the 2014 HIQA report.  That Action Plan has also been published today

View the full report here

Last updated on: 18 / 05 / 2016