Ambulances routinely held up for an hour or more at A&E departments

The HSE’s target turnaround for ambulances is 20 minutes

An ambulance is prepared by Colm Murphy at Tara Street fire station in Dublin. Photograph: Cyril Byrne

An ambulance is prepared by Colm Murphy at Tara Street fire station in Dublin. Photograph: Cyril Byrne

Mon, Mar 17, 2014, 01:00

Delays in ambulance response times have been much in the news recently and, while there may be a number of contributing factors, a significant one is the length of time ambulances can be held up at hospital emergency departments.

For years, those working in the health service have highlighted how large numbers of patients on trolleys in emergency departments can have knock-on effects.

These are not just on patients who suffer the indignity of waiting hours and even days in overcrowded A&Es, but also on the problems for ambulances when they arrive with new patients – finding a place for the patient so the ambulance team can take the patient off its trolley and depart to attend a new 999 call.

Just exactly how much time has not been clearly documented up to now.

Previously unpublished figures obtained by The Irish Times under the Freedom of Information Act indicate many ambulances are routinely being held up for an hour or more at emergency departments when the HSE’s own target turnaround time for these ambulances is 20 minutes.

In every region of the country in 2012 and 2013, these targets were being missed.

The HSE’s own figures show that, in the east, ambulances were constantly delayed at least an hour in about 40 per cent – and up to 48 per cent – of cases in the first eight months of 2013.

By December 2013, the situation had improved but still almost one in 10 ambulances had a turnaround time of greater than 60 minutes in the final month of last year.

How much longer than 60 minutes they had to wait is not documented in the figures.

In the northwest, 18 per cent of ambulances in December had a turnaround time of greater than 60 minutes.

Wait-times were longest in the midlands last year.

Ambulances were waiting at least an hour in more than 80 per cent of cases in January, March, May and July, before being able to leave patients in emergency departments and depart on a new call.

In February, April, June, August and September, they were waiting an hour or more in over 79 per cent of cases.

While the situation had improved by December to hold-ups of an hour or more in 29 per cent of cases, this means one in three ambulances are still being held up for that period in the midlands.

The data is not broken down to reveal which hospitals had the longest delays.

Looking at where targets were met, in the east in December 42 per cent of ambulances had turnaround times of 20 minutes or less; in the northwest the target was met in 19.5 per cent of instances; it was met in just over a quarter of cases in the southeast; and the best performance was in the Dublin Fire Brigade ambulance service, where 55.7 per cent of ambulances met the target turnaround time.

The HSE, in its December 2013 National Performance Assurance Report , identifies the problem as a key obstacle to improvements in ambulance response times.