Hiqa review: Ambulance service resources are too low

The ambulance services in Ireland need more resources if target response times are to be met, a review by the health watchdog has found.

In 2014 the Health Information and Quality Authority carried out a review of what it described as “prehospital emergency care” — focusing on ambulance services in particular.

In March, it published its review of the progress the ambulance services has made in implementing Hiqa’s recommendations.

It looked at both the National Ambulance Service as well as the Dublin Fire Brigade, which shares responsibility for prehospital emergency care in the capital.

While it had found that improvements had been made, the progress review said “it was also evident that more needs to be done to achieve better operational efficiencies in both services”.

“Response times have remained stable but have not improved since 2014, in part because demand has increased,” the progress review stated.

“In addition, there is still scope for improved efficiency in the use of resources. Nonetheless, resources in both services still remain too low to enable a significantly improved approach to reaching target response times,” it said.

It said that in 2014, recruitment rates were too low to keep up with staff losses, but that this has been addressed.

Hiqa said that in 2014 “staffing numbers were falling at a concerning rate due to recruitment levels being too low to keep up with staff attrition rates”.

Since then, however, it said the National Ambulance Service “has stabilised and enhanced the workforce complement”.

Despite this, problems remain according to Hiqa.

“However, staff numbers still fall well short of the identified required level, and the service remains reliant on overtime to maintain services,” it said.

“While the number of trainee paramedics recruited in both services since 2014 has increased, a staffing shortfall remains.

“Recruitment of trainee paramedics is restricted to the number of training places currently available, and the ability of the service to be able to absorb and appropriately supervise new recruits,” Hiqa found.

In the review, Hiqa further warned that “as a consequence of the poor state of workforce planning... an ongoing reliance on overtime will be required for a number of years while yearly recruitment builds capacity.”

Elsewhere, while Hiqa welcomed the increase in the number of community first responder schemes that have been developed in rural areas across the country, it warned that “more needs to be done to provide assurance that all registered community first responder schemes that are linked to the National Ambulance Service, are in compliance with the National Ambulance Service policies, procedures and guidelines”.

“In addition, greater effort to strategically encourage the establishment of schemes in priority areas which might significantly benefit from them due to the rural nature is also needed,” Hiqa said.

“As things stand, such schemes have not been set up in large parts of rural Ireland which might benefit most from their establishment.”


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