Patients who are in a life-threatening emergency are being put at serious risk because of failures in how the Dublin ambulance service is run, a major watchdog report warns today.
The patients are in danger of having to wait longer than they should for a 999 ambulance to arrive in some critical situations because of the way the service is operated by the Dublin Fire Brigade, the report by Hiqa revealed.
A key problem is the ongoing lack of integration between the Dublin Fire Brigade service and the HSE-run National Ambulance Service despite improvements in co-operation in recent years.
Dublin Fire Brigade is run by Dublin City Council and the National Ambulance Service , which caters for the rest of the country, is part of the HSE.
The lack of proper integration between both means that if a patient with a potentially life threatening condition in Dublin dials 112/999 for an ambulance, current arrangements for call handling and dispatch can result in a delay in response.
This is due to the way calls are transferred from Dublin Fire Brigade to the National Ambulance Service.
A Dublin Fire Brigade ambulance may continue to be dispatched to the patient even though a nearer National Ambulance Service ambulance may have been available and better placed to respond.
“The status quo puts patients at risk and cannot be allowed to continue,” warned Sean Egan, Hiqa’s Acting Head of Healthcare Regulation.
“It is, therefore, incumbent on those with overall governance responsibility for publicly-funded ambulance services in Ireland to ensure that there is a clear plan for the future of services in Dublin that is based on ensuring the safest and best possible service for patients.”
The findings are released in a progress report following a 2014 of the service by Hiqa which highlighted the problems.
It found progress has been made in pre-hospital emergency care across the HSE-run service nationally.
It has moved to a single control centre over two sites and this has improved the service.
“Furthermore, the National Ambulance Service now has a very clear understanding of what it needs to do to progress services and is better governed and supported by the HSE to progress this improvement”
However, the National Ambulance Service still lacks necessary capacity and, despite increased recruitment it remains reliant on overtime to maintain services.
The most serious problems remain in the Dublin area. Hiqa said that in Dublin, it was clear that significant shortcomings remain that put patients at risk
While lines of communication, formal governance arrangements and working relationship at senior management level within the HSE and Dublin City Council were much improved, a detailed plan for the delivery of emergency ambulance services in the greater Dublin area still does not exist.
Firefighters who are members of Siptu last month voted for strike action over proposed reforms to the emergency medical service operated by the Dublin Fire Brigade.
Siptu said Dublin City Council planned to break up the Dublin Fire Brigade emergency medical service by outsourcing its ambulance call and dispatch function.
The action, which was also supported by IMPACT, was due to take place on March 18 and 27 but it was deferred following a commitment by Dublin City Council to enter into an independent process, chaired by the former Director General of the Workplace Relations Commission, Kieran Mulvey.
SIPTU said the management of Dublin City Council had also given an unequivocal commitment that this process will be the sole and singular forum for consideration of all of these issues.