Saturday 1 October 2016

Lives at risk as just one in 15 arrives 8 minutes after call

Published 09/05/2016 | 02:30

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The majority of ambulances are taking too long to respond to life-threatening emergencies where patients may be suffering a cardiac arrest, major bleeding or choking, a damning confidential report has warned. Just 6.6pc of call-outs - barely one in 15 - met the target of reaching a stricken patient in a rural area within the target time of eight minutes. Even in major urban areas, only 36.7pc, or just over a third, of ambulances arrived within the target time. The other target response time, of 19 minutes, was only reached in less than half of emergency cases where patients were deemed to be in potentially life-threatening predicaments, including car crashes. The audit of performance over six months, contained in an expert report commissioned by the HSE, did not measure the impact of the failure to meet targets on the patients' chances of survival or the harm they suffered. However, each year between 3,000 and 5,000 people die from heart attacks and the chances of survival for someone who suffers a cardiac arrest outside of hospital is just one in 15. The findings are in the latest in-depth ambulance review, by UK consultants Lightfoot Solutions, which was obtained by the Irish Independent. The consultants warned that Ireland was too rural to meet these targets and concluded that - even on the assumption that the HSE's National Ambulance Service is fully resourced - the best that could be hoped for would be a modest improvement. Only 60.6pc of ambulances could meet the eight-minute target, according to their analysis. "In Ireland, 40pc of incidents are in a rural location, compared to 12pc in a typical English service," they found. The report suggests a range of changes and recommends, controversially, that overtime by ambulance staff should be cut to pay for extra investment. An additional 290 full-time staff would be required to deliver core additional hours, according to the consultants. The report says: "Front-line overtime levels in the national ambulance service currently account for 20pc of the pay bill. "If we assume that 10pc overtime is required for shift overruns and other unavoidable causes, that leaves 10pc of the pay bill that could be used to pay for extra staff. It is equivalent to around 139 staff." It also calls for a review of the points from which the vehicles start in ambulance stations. "In many cases, the ambulance stations, which are used as deployment points, are not well located for the communities they serve. As a result, average drive times in urban areas are nearly 10 minutes compared to about four in high-performing services." Response times could be improved in major urban areas by the extended use of rapid-response vehicles as well as additional ambulances. More use, the report says, could be made of community first responders, who are trained in the use of defibrillators in cases of cardiac arrest. However, the consultants also says that these volunteers are not a replacement for the ambulance service.

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