The 2014 report identified that there was significant scope to improve ambulance services for patients in Ireland. HIQA identified that many of the improvements required could be achieved within existing resources, through improved management of the service. 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 both service providers. Against the backdrop of this original HIQA review in 2014, the National Ambulance Service had already started to reform and reconfigure its service.

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. These key areas are:

• the level of coordination and cooperation between the National Ambulance Service and Dublin Fire Brigade when providing services to the people of Dublin
• clinical governance and risk management in the National Ambulance Service
• the degree to which both service providers had improved how they monitor and measure the quality and safety of their services, and progress in improving performance against these measures since 2014.