Dáil Éireann Debate, Wednesday - 19 December 2012
22. Deputy Denis Naughten asked the Minister for Health the progress which has been made in the Health Service Executive West region since the introduction of standardised ambulance response times; the steps being taken to improve ambulance response times in the region; and if he will make a statement on the matter. [56889/12]
View answerThe Health Information and Quality Authority has developed a suite of key performance indicators (KPIs) within which 999 emergency calls have been classified by clinical status.
Clinical Status 1 Echo calls involve life-threatening emergencies of cardiac or respiratory origin. Clinical Status 1 Delta calls involve life-threatening emergencies of other than cardiac or respiratory origin. The target times for responding to Echo 1 and Delta 1 calls are 7 minutes 59 seconds by a first responder (a person trained in minimum basic life support and use of a defibrillator) and 18 minutes 59 seconds for a patient-carrying vehicle. With effect from January 2012, HIQA have set the standard for first responders at 75% within the target time and at 80% within the target time for patient-carrying vehicles.
Response times around the country vary significantly and are influenced by the nature of the area covered and the rural/urban mix. As might be expected, the percentages for achieving optimum response times are lower in remote areas of the country. The following table sets out response times for August 2012 by the three operational areas.
|
NAS Area |
ECHO First response within 7 mins 59 secs (Target 75%) |
DELTA First response within 7 mins 59 secs (Target 75%) |
ECHO Transporting vehicle within 18 mins 59 secs (Target 80%) |
DELTA Transporting vehicle within 18 mins 59 secs (Target 80%) |
|
North Leinster |
74.03% |
30.51% |
62.99% |
69.20% |
|
South |
44.44% |
28.53% |
74.07% |
66.60% |
|
West |
41.67% |
25.98% |
86.11% |
62.25% |
It is important to note, however, that following a review of the validity of time-based KPIs for clinical status data, and in line with international views , it is considered that clinical outcome indicators would be more appropriate, and work has begun on their development. I also welcome the consequential outcome that use of clinical indicators will enable a focus on Clinical Status 1 (Echo and Delta) calls.
The National Ambulance Service (NAS) has been taking a number of steps to improve response times. These include development of a Performance Improvement Action Plan, an intermediate care service, the control centre reconfiguration project and a trial emergency aeromedical service.
The Performance Improvement Action Plan is focused on achieving an improvement in response times performance. This plan has 57 action points for improvement which are being worked through by local managers, in areas such as faster mobilisation times for crews; improved processes for call taking and dispatch; engagement with and development of community first responder schemes.
The intermediate care service (ICS) is intended to provide non-emergency stretcher-based transport, such as for inter-facility journeys, so emergency vehicles are available for emergency duties and response times can be improved. In this context, the NAS and staff representatives have signed off on a Framework Agreement for the development of an ICS within the NAS, specifically to free up emergency resources for emergency calls. Almost 50 intermediate care operatives have been appointed across the country, in areas including Cork, Galway, Sligo, Letterkenny, South Dublin.
Through its control centre reconfiguration project, the NAS is continuing to rationalise the number of ambulance control rooms across the country, with a target of one system across 2 sites - Tallaght and Ballyshannon. The current total is nine. is project is focused improving call taking and dispatch functions and on delivering improved technology. is will assist in improving response times and will allow the NAS to deploy resources in a much more effective and efficient manner, on a regional and national basis rather than within small geographical areas.
The Emergency Aeromedical Service (EAS) was initiated as a 12 month trial in June 2012, with two purposes - to reduce the transit time to an appropriate facility for certain conditions, particularly in the west, and to determine the extent, if any, of the need for aeromedical support to the NAS and, if required, how best to provide it. The trial involves the Irish Air Corps providing aeromedical support to the HSE NAS, from a base in Custume Barracks, Athlone. The aircraft is operated by the Air Corps, with clinical staffing from the NAS. The Irish Coast Guard also provides additional support to the primary aircraft, using its new search and rescue helicopter in Shannon, which is staffed by its own paramedics and an NAS advanced paramedic when necessary.
