Ambulances told to reach critically-ill patients within 8 minutes

STRICT new ambulance target travel times which could drastically improve the pre-hospital emergency care sector have been announced.

In an ambitious new plan by the Health Information Quality Authority (HIQA), all HSE, private sector and fire brigade ambulances have been given the target of reaching critically-ill patients within eight minutes.

Under the system which is set to be introduced by the second half of the year, a target of 75% of “first responder” call-outs for incidents such as heart attacks or life-threatening respiratory arrests must reach their patient within the timeframe.

First responders include ambulance crews, advanced paramedics and paramedics.

Serious but non life-threatening call-outs must reach their destination within 19 minutes, according to the plan.

HIQA said the life-threatening category figure was based on international norms, with up to 73% of this type of ambulance call-out in the North regularly coming in within the target.

Due to historical issues, HIQA said the HSE does not keep a comprehensive record of times for different emergency categorisation.

However, a nationwide Irish Examiner investigation in late 2008 revealed patients in south Tipperary, Carlow, Mayo, Galway, Waterford, and Wexford are waiting, on average, close to 90 minutes before admission to hospital by ambulance.

In addition, a HSE performance report last October found that just 27% of emergency ambulance call-outs reached their patient within eight minutes.

HIQA’s director of quality and safety Jon Billings said in order to ensure service shortfalls are identified, the HSE will publish detailed ambulance response-time performances in each region from the second half of this year after a phasing in period starting this month.

Mr Billings said it was unlikely more money or resources will be made available to the ambulance service to address the measures.

However, he added that structural changes will be put in place in an attempt to ensure ambulance waiting times are significantly lowered.

“This is not an overnight thing, you can’t make the changes straight away. That’s why we’d expect the HSE to introduce the changes that are needed.

“The time indicators are there as a tool, and we are using that to drive down times,” he said.

Under the plan, the HSE will be expected to show definitive proof of call out travel times being shortened year-on-year.

The move has been welcomed by opposition parties as a vital step towards pre-hospital healthcare reform.

However, it is unclear whether there will be disciplinary measures or penalties imposed if the target levels are not met.

In mid-2007, the HSE published stringent new targets for emergency department waiting times in hospitals. The plan included a “zero tolerance policy” for trolley waits and target total waiting times of six hours — ambitions which have yet to be achieved.