Patients in Dublin are being put at risk because of a lack of adequate ambulance cover in the capital, according to a HIQA review of pre-hospital emergency care.
The investigation shows a problem in Dublin in relation to ambulance capacity.
It found a high number of potentially life-threatening calls are being placed in a queue rather than having an ambulance dispatched straight away, which is putting patients at risk.
Sean Egan, HIQA’s Acting Head of Healthcare Regulation, said: "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."
He highlighted the improvements that have already been made in the ambulance services, but he said the service needs a clear plan to ensure a safe service for patients.
Mr Egan said: "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."