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Dublin: 10 °C Wednesday 22 May, 2013

National targets for ambulance response times to be abandoned

James Reilly is to come up with alternative ways of measuring the performance of the National Ambulance Service.

Karl Macken (2) helps launch a stroke awareness campaign last month.
Karl Macken (2) helps launch a stroke awareness campaign last month.
Image: Photocall Ireland

NATIONAL TARGETS for the response times by which an ambulance should be dispatched to deal with a life-threatening medical emergency are to be abandoned.

The Minister for Health, James Reilly, says alternative methods of evaluating the performance of the ambulance service will be formulated.

The decision comes only weeks after HIQA increased its targets for response times for ambulances and medical personnel who are called to a life-threatening cardiac or respiratory emergency.

Since January of last year, ambulances responding to such emergencies – known as ‘ECHO’ calls – were due to respond to 75 per cent of calls within 18 minutes and 59 seconds of being alerted. Last month the target was raised to 85 per cent.

Separate targets for both ‘ECHO’ and ‘DELTA’ calls, involving life-threatening conditions not involving cardiac or respiratory problems, are that a first responder trained in defibrillator use and minimum life support skills should be dispatched – ahead of an ambulance – within 7 minutes and 59 seconds.

In response to a Dáil question from Richard Boyd Barrett, Reilly said the decision to review the analysis criteria was “in line with international views” and also followed other changes including the operation of a trial air ambulance service and the formulation of a Performance Improvement Action Plan by the HSE’s National Ambulance Service.

Reilly did not indicate whether HIQA’s current targets had been met, instead referring the query on to the HSE.

He said, however, that the use of clinical indicators would “enable a focus” on ECHO and DELTA calls.

Responding to similar questions last year, Reilly said the targets for first responders were met for 53.1 per cent of ECHO calls in 2011, while the targets for DELTA calls were met only 28.45 per cent of the time.

On that instance Reilly said part of the difficulty in dispatching ambulances in time was the habit of using ambulances to transfer patients between hospitals, which tied them up and left them unavailable to respond to new urgent calls.

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Comments (51 Comments)

  • Responding to ECHO and DELTA calls within 8mins is usually only going to be feasible in urban areas unfortunately. A lot of places are more than 40-50 mins from an ambulance station. Rapid response cars might be a way to stop the clock in rural areas but its only a stop gap until an ambulance comes. Have to agree with the minister in respect to emergency ambulances being tied up on transfers and GP urgent/taxi calls. Something needs to change here…

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  • I guarantee minutes could be made in rural areas, if they introduced postcodes.
    My job does not involve saving someones life, but time is lost only having a townland which could be 1-5sq.mi in area as an address when calling the ambulance service.

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    • Or if people – both in the emergency services and people who may call them – simply learned to use Google Maps to find exact longitude and latitude. Right-click (ctrl-click on Mac) on the spot in the map, go to ‘What’s here?’ and the longitude and latitude appear in the search field, eg 52.502168,-6.569009. Then the ambulance driver can use an iPhone or satnav to drive straight to that point.

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    • Google Maps during an emergency? Ain’t nobody got time for that!

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  • It’s very hard for Ambulance crews to reach their targets
    when the HSE has dropped Ambulance cover from certain areas
    Only this week there was no HSE Ambulance in Swords on Tuesday,
    no Ambulance in Tallaght on Monday and Thursday
    Also there were Ambulances withdrawn from city centre stations
    and also in Wicklow and Kildare
    How can the government look to improve inefficiencies in the health service
    when €200000 worth of equipment and vehicles are left idle in Ambulance stations
    with no crews to man them
    People need to wake up and realise what’s really going on

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    • Joyce, their unions need to do more to highlight this, and let the public be in no doubt how bad things are.

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    • There is no ambulance dropped in any of them stations. They are covered by non rostered staff when there is no rostered staff in on the days. This is what the unions signed up to in Croke park. So if any thing blame the unions. This was there way of turning a 40 hour week into a 39 hour weeks. The papers are all about headlines!

      “Ambulance service roster changes result it shifts being covered by non rostered staff doesn’t make good headlines. But “ambulance service roster changes result in shift being dropped” does. It’s all in the fine print.

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    • Abdul I would ask you to check your facts before you post
      As I said their was NO Ambulance in Tallaght Monday or Thursday
      NO Ambulance in Swords on Tuesday and Wicklow and James street dropped an Ambulance each
      None of these shifts were covered by non rostered staff

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    • Can you send me on the facts that you have. As unless this is happening only in the last week I thing your source is incorrect.

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    • There were DFB ambulances in Swords and Tallaght on these nights but these resources are already under pressure without the loss of HSE crews.

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  • At least he’s not blaming the people on the ground but I don’t suppose it ever crossed his mind to lift the recruitment embargo.

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    • What embargo? The National ambulance service haven’t been affected by the embargo. They have started a good lot of emts and trainee paramedics and EMCs over the last few years with a current recruitment for emts for the ICS.

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  • I live in a small village (less than 7 mins from an ambulance station) . Everyone had their own version of their address, no house numbers… Even worse in the country side..can’t be easy in estates with crap numbering either….
    Do think emergency ambulances being tied up doing routine transfers is a bit daft (and expensive)

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  • Barty 15/02/13 #

    Senior Fire Officrrs are refusing to send retained firefighters on ambulance assist calls. Majority of these calls are for cardiac arrest. The decision to assist the citizens of this country in an emergency is now been by made bureaucrats and white shirted bean counters who think they are GOD.

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  • timed measurement is meaningless. often one responder cars are sent to “stop the clock” and make the call a success.
    equally an ambulance can arrive on scene within time and the patient can be dead or can die during treatment/transport and the call is deemed a success, whereas an ambulance can arrive outside the time and the patient recover/respond to intervention and the call is deemed a failure.
    would be nice to see what measurement they adopt

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  • He will need to set up a commitee of some sorts to come up with a solution and then get a quango to advise the commitee about how to be a commitee and I belive his uncles/sisters/brothers best mate could be the chairperson…ofc it will all be above board and if not he will make a commitee to investigate if it was above board in the beginning..with offices in Balbriggan ofc.

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  • Stop cutting our ambulances so! North Kildare has lost it’s ambulances on a Thursday for 12 hours. If anyone is interested in the campaign to get them back check us out on fb: https://www.facebook.com/StoptheNorthKildareAmbulanceCuts

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  • Again front line staff take the blame for the actions of management and their masters. These guys and girls do a terrific job but once again Dicey Reilly and Co Are playing with figures while people suffer and die. All front line staff should down tools stick together and fight this Puppet Government and their pay masters in Europe who don’t give a Dam about the Irish People.

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  • How can paramedics respond with the road network in rural Ireland not being built for speed. Rallying around in a 4.5ton van on them roads are not safe for crew and other road users. The fact that people live in town lands and not on streets also makes it harder to find people. Local knowledge is key but still the distances are quite large and it wouldn’t be uncommon for a echo call to have a response time of up to 45mins in some areas.

    The helicopter I personal do not thing is being utilised to its full advantage. It is being used more as an advanced patient transport vehicle than a true HEMS service where the calls would be screened and the heli dispatched to the location with out the need for a land ambulance attend the scene.

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  • Olga I completely understand your worry when your child is sick and you are waiting for someone to come and help, it is and can be very frightening. However, even if the ambulance bay is 3 minutes away you may find that their one was already out on a shout and you where getting an ambulance from another station Hence the delay. Unfortunately due to the lack of ambulance in each station things are not always as black and white as they may seem. I hope your child is on the mend now.

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    • Look I totally agree but it turns out that the ambulance was dispatched only when I rang the second time due to an error and that is FACT.

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    • An error in dispatching is a big difference than to say that they were sleeping and implying that they couldn’t be arsed coming out to your child because they’re sleep was more important. That is an insult to the people that go out in all conditions, for every kind of emergency see things that effect them for the rest of there life, some things that they wish they never seen. But there life at risk because there is just no other way Just so they can help people in need to ease there suffering. When a good job is done no one hears about it, but people have no problem slating the people for things out of there control.

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  • Sounds like a cop out. I don’t believe there is enough ambulances strategically placed in rural Ireland to cover rural locations.

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  • Another logistical logarithmic progression no doubt.

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  • Nocturnal paramedic some Ambulance stations still have beds and still have on call

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  • So let me get this straight. The current HIQA method of measuring the response times of ambulances to life threatening emergencies shows we are failing to meet the target response times, terribly. The minister’s response to this, as these targets are due to be raised, is to abandon all measurement altogether. Presumably he can then claim if its not measured that there isn’t a problem.
    If this works he may stop counting those on trolleys in A&E Departments, after all if nobody counts them they aren’t there.

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  • Just want to say that the Ambulance Crews do a terrific job. They have to deal with a hell of a lot of shit but I had to wait longer than I anticipated…..that was my point!

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  • Makes sense if your are in power, disempower those that could highlight your failures….so much for a new politic

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  • I just realised that this article arose from a question the Stop the North Kildare Ambulance Cuts Campaign submitted to Minister Reilly with the help of Richard Boyd Barrett (none of our own TDs would even bother!). Reilly referred it to the HSE and they sent us a disgusting and upsetting response, essentially deny the existence of any cuts.

    I don’t want to post the response and our reply to it here as it’s huge but if people are interested they can find it here: https://docs.google.com/file/d/0B2HuXtwM29-rd0hvSjk3Z3FCR3M/edit?usp=sharing

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  • there is such a thing as on call in many areas which can lead to an ambulance being delayed by a considerable length of time trust me i know i do it 7 nights every 6 weeks for 15 hours per night.

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  • The whole thing is a joke! How often do u get sent on a emergency call 50 miles away just because your the nearest available ambulance? Just so control get there 90 second response time! Then to be stood down 10 miles into your journey!!

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  • well I needed an ambulance for my baby the week before last who was convulsing for over 15 minutes and the response time should have been 3 minutes but it took 24 minutes and 2 phonecalls to get them here at 01.30am. and no they were not at another call out they were in bed! It was one of the scariest moments to see my baby going through that :-(

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    • So you honestly think that the ambulance crew where lying in bed (no stations have beds) and they just decided “ah sure we’ll just sleep for another 20 mins and then respond to that call”…??? Obviously the nearest ambulance was 24 mins away and that’s why it took that long to arrive. You can blame a lack of ambulances for that and people misusing 999.

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    • listen beds or not the ambulance took 24 minutes just like i said. I dont care what you believe. I had to ring 999 twice just like I said above. AND the station is 3 minutes drive from my house. what part do you not understand? apart from the bed remark which was probably the wrong thing to say the rest is fact. They apologised for the delay. I called 999 twice, the second time was to ask where the ambulance was and why it wasnt here after waiting 15 minutes already! Im not trying to upset anyone just stating true facts of what happend

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    • @olga I hope your small one is ok now but even though the ambulance base is 3-4 mins away they were probably returning from the hospital. They are usually very fast when it involves a child. I remember given CPR on a male in his early 60′s and waiting for 30 mins. Unfortunately it’s not the paramedics fault as nocturnal has said there are way too many time wasters abusing the service and system. And not enough of them for the area covered. I know for the whole of county cork we have been told that there is 14 ambulances on duty (I’m open to correction on that figure)

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    • I know its not. Like I said above, its what happend!

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    • Thanks by the way shes on the mend. :-)

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    • Just because there is an ambulance station beside you doesn’t mean there is one there all the time. In some areas when the ambulance goes out on a job it could be out of the station for any thing up to 4 hours. If the ambulance is fit for duty after a job it will be sent if it is the nearest available resource. Some times the ambulance needs to go back to base to restock and decontaminate if needs be.

      I understand that your 2 mins form a station but if there is no crew there’s no ambulance. A lot of stations have a day and a night ambulance (2 ambulances on station) but if there is only one crew on durning the night there is only one ambulance available to respond. It may look like there is one parked out side and that every ones asleep but that’s because the crew is more then likely out.

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    • It is supposed to be an *emergency* service. Why do many red thumbs and pathetic excuses?

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    • Mursh 16/02/13 #

      @Olga. You make a very serious accusation ” no they were not at another call out they were in bed”.
      What proof do you have of this?

      You are saying that Paramedics ignored a call for 20mins, that would have very serious ramifications to them if reported as I sure you did, seeing as you know for a fact that they weren’t at another call.

      @censored . Yes it is an Emergency service but strangely enough there can be more than one emergency at a time. An Ambulance is not a magic machine that can teleport to where it’s needed. It’s a van (a heavy one) that can only do one case at a time . If it’s busy then either the call has to wait or the will be given to next nearest ambulance which down the country could be 30km away.

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    • if u read my comments you would see I never mentioned the word ignored or 20 minutes! so dont be telling me whats serious and whats not. My daughters health and safety is my priority OKAY!

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    • Mursh 16/02/13 #

      @Olga. You’re right I rounded it to 20 mins when it was 21, 24 minutes to get to you – 3 minutes you believe they should have arrived leaves 21 minutes they ignored the call and stayed in bed (by your insinuation)

      So I’ll ask you again what proof do you have that they were at the station asleep and did not bother to respond for 20 mins?

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    • They could very easily have been in bed if they crew were on call which still goes on in many areas.

      Reply

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