Ambulance service response times differ significantly depending on location

The Health Service Executive has pointed to "demographic and geographical challenges" as a major factor behind significant differences in response times for patients who contacted the National Ambulance service last year.

The time it took to respond to patients reporting life-threatening emergencies last year differed significantly depending on where they lived, according to data released to The Irish Times under the Freedom of Information Act.

The Health Information and Quality Authority recommends that life-threatening cardiac or respiratory arrests (Echo calls) and other life-threatening emergencies (Delta calls) should receive “first responder” medical attention in under eight-minutes in three quarters of all cases.

According to its recommendations advanced paramedics, paramedics or cardiac/emergency first responders should reach the scene in under eight minutes. For most of 2012, it recommended that an ambulance or “patient-carrying vehicle” should reach the scene in under 19 minutes in 80 per cent of cases. Since December it has been revised upwards to 85 per cent.

However, the eight-minute target was not met in any of the three National Ambulance Service areas according to the figures compiled for the HSE’s monthly performance reports in 2012.

Response times for those with life-threatening cardiac emergencies were worst for those living in the west of Ireland (Galway, Mayo, Limerick, Clare, North Tipperary, Roscommon, Sligo, Leitrim, Donegal) with just a third of calls receiving medical attention within eight-minutes.

People living in the “North Leinster” area (comprising Dublin, Wicklow, Kildare, Laois, Offaly, Meath, Westmeath, Longford, Cavan, Monaghan and Louth) received medical help within eight minutes in 60 per cent of life-threatening cardiac emergencies.

Those living in the southern region (composed of Cork, Kerry, South Tipperary, Waterford, Wexford, Carlow and Kilkenny) received medical help for cardiac and respiratory emergencies within eight minutes in 42 per cent of cases.

Response times for non-cardiac life-threatening emergencies were significantly lower. Just 30 per cent of calls made in the southern region were reached within eight minutes (when the target is 75 per cent) with a 27 per cent response rate in “North Leinster” and in the west.

Medical personnel
When these response times were put to the HSE, it said it believed the response times achieved were under represented in the data. It said

it “does not have the technical capacity at this juncture to capture such data, therefore, current performance is significantly under reported”.

Asked about the disparity between the three ambulance regions, the HSE said the western and southern were very dependent on medical personnel who were “on-call” rather than “on duty”.

It also cited demographic and geographical challenges in these areas and to “the fact that Ireland continues to use emergency ambulances for inter-hospital transfers”.

The HSE spokeswoman added that capacity does not exist “anywhere in Ireland to meet current response times targets and it would take several years of significant investment to bring Ireland’s services into line with the UK or Northern Ireland where such standards and the associated investment has been in situ for 20 years.”