The Covid-19 pandemic has had a massive and sustained impact on the health service, with many sectors still struggling to recover.
But of all the areas affected, the ambulance service appears to be the most challenged. Internal documents disclosed by The Irish Times this week point to the National Ambulance Service (NAS) being unable to keep up with demand from patients, and unable to recruit sufficient numbers.
Recruitment “is being surpassed by demand for the organisation’s services” which “poses a serious risk to the ability of the NAS to deliver urgent and emergency care services”, the documents state, adding that there is a “critical and immediate need to increase workforce capacity”.
None of this will come as a surprise to anyone who studies HSE data. The most recently published “performance profile” for the organisation, dating to the last quarter of 2021, shows the ambulance service is falling abysmally short on meeting its targets.
Ambulances are supported to be ready again for transporting patients within 30 minutes of arriving at a hospital, for instance. Yet only 27.4 per cent of ambulance turnarounds were done within this half-hour target last year. That means three out of four ambulances were not ready when they should have been, leading to delays in available vehicles to dispatch in response to emergency calls.
The situation is much worse in some parts of the country. Only 12 per cent of ambulances in the Saolta University Healthcare Group (the west and northwest) were turned around within 30 minutes. The South/South West Hospital Group wasn’t much better, with 16 per cent of ambulances hitting the target.
Three out of every four of the most serious “Echo” calls (life-threatening cardiac or respiratory arrest) were responded to within 19 minutes, not far short of the 80 per cent target. But for “Delta” calls (also life-threatening but not involving cardiac or respiratory arrest), just 44 per cent were responded to in that time frame.
Where delays occur, the calls are supposed to be escalated within 30 minutes. By the end of last year, however, this was happening in only 62 per cent of cases.
One reason for these delays is increased business. More people are ringing 999/112. Echo and Delta calls for seriously ill patients were up 25 per cent last December compared with December 2021.
And while last year saw a net increase of more than 6,000 staff across the health service, just 70 of these were in the NAS.
The ambulance service has the highest absence rate for staff of any sector in the health service, at 10 per cent, the figures show. Covid-related absence accounts for only one-quarter of this.
Ireland isn’t unique in having problems in its ambulance service. In the UK latest data for ambulance performance has been described as close to its worst.
Given the chronic nature of the problems with the NAS, and the likelihood it will come under renewed pressure from future waves of Covid-19 infection, there is an urgent need to review the service and tackle the cases of underperformance.