The Health Information and Quality Authority (HIQA) has today published a review of progress in implementing the recommendations of HIQA’s 2014 review of pre-hospital emergency care services.

Today’s report, entitled Review of progress made in implementing recommendations following HIQA’s review of pre-hospital emergency care services, found that while progress has been made in pre-hospital emergency care provision in Ireland, serious issues remain in the organisation of these services in the Dublin area. 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: the National Ambulance Service and Dublin Fire Brigade.

Sean Egan, HIQA’s Acting Head of Healthcare Regulation, stated “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 relates 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 continued “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.”

ENDS

For further information contact:

Marty Whelan, Head of Communications and Stakeholder Engagement, HIQA, 01 814 7480 / 086 2447 623, mwhelan@hiqa.ie

Notes to the editor

• Today’s report is a follow-up review on HIQA’s Review of pre-hospital emergency care services to ensure high quality in the assessment, diagnosis, clinical management and transporting of acutely ill patients to appropriate healthcare facilities, which was published on 2 December 2014.
• The 2014 HIQA Review can be found at the link below
• The 2014 HIQA Review was undertaken at the request of the then Minister for Health following concerns raised due to a number of publicly reported patient safety incidents relating to pre-hospital emergency care in Ireland at that time.
• The 2014 HIQA Review outlined 12 high-level recommendations to be implemented which required significant changes in leadership, strategic planning, funding, cooperation and coordination of services by Ireland’s two publicly funded services: the National Ambulance Service (covering most Ireland) and Dublin Fire Brigade (covering most parts of Dublin).
• This follow-up review by HIQA began in July 2016 and aimed to determine the level of progress made in implementing the recommendations of the 2014 HIQA Review. It focused on a number of key areas which were identified as needing significant improvement.