The National Ambulance Service (NAS) is more than one third short of its staffing targets, according to figures from the HSE, and the service said it would take “several years” of sustained investment to reduce the “widening gap” between demand and supply.
Pressure on the service has been increasing in recent years, with demand for ambulances via 999 emergency calls having increased by 25 per cent since 2019.
Senior health officials have widely acknowledged that staffing levels are short of what is required to meet the increased demand.
In 2022, the HSE developed a workforce plan for the service, which set out end-of-year annual targets for recruitment. However, these targets have not been met since being established.
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In 2023, the “aspiration” was to have 2,853 whole-time equivalent staff, but there were just 2,321 approved positions by the year’s end. The target rose to 3,548 in 2024, with 2,339 posts approved at the end of that year. Last year, the workforce plan had a goal of 4,162 posts, but just 2,547 were approved.
For this year, the workforce plan sets out a target of 4,780 posts, and there are 2,920 approved, which includes 263 whole-time equivalents covered under new service development funds.
Robert Morton, director of the service, said progress against the 2022 workforce plan “remains dependent on the availability of new service development funding in each year and the prevailing employment controls in place in each year”.
“The HSE National Service Plan (NSP) in the current year provides for additional resources as part of planned new service developments in 2026,” he said.
“However, it will take several years of sustained consistent investment to reduce the widening gap between rapidly rising demand and the capacity available to respond to that demand.”
In 2025, ambulance service staffing in the UK averaged 1,000 per million of population compared to less than 500 per million of population in Ireland. However, the number of staff has increased by 528 whole-time equivalents since 2019.
The figures were released to Sinn Féin health spokesman David Cullinane in response to a parliamentary question. He described the service as being “miles behind” its targets, adding that the staffing shortage was “what’s feeding into the discontent”.
He said “working in an under-resourced service, that creates its own challenges”.
“I’ve heard from paramedics, they’re on a shift and five or 10 minutes before the shift ends they might get sent 100 miles away,” he said, adding that there is “burnout” due to having to work longer hours.
“It’s completely unacceptable that we’re way behind what’s international best practice. Scotland has a much better population to paramedic ratio than we have. Targets were set and we haven’t met them. It comes at a price of fatigue, burnout and a lack of trust.”
A spokeswoman for the HSE said the service has “no recruitment issues” and operates at “full-funded capacity”.
“Training places at the NAS College are highly sought after, with the most recent recruitment competition for student paramedics attracting the highest number of applicants ever, with over 1,000 people applying in 2025,” she said.
She said the NAS is undergoing “significant transformation” and has received an additional €83 million since 2022 to its base budget.
