Ambulance response times falling far short

Neill O’Neill 

THE HSE’s Ambulance Service in the west of Ireland is only meeting approximately half of its targets in terms of response times to the most urgent of calls. For calls where a person’s life is deemed not to be in immediate danger, those response-time rates drop dramatically.
HIQA guidelines state that for at least 70 percent of most-urgent calls (known as ECHO calls) and 68 percent of less-urgent (or DELTA) calls, a first responder must be with the casualty within eight minutes, and the Ambulance Service must be with the casualty within 19 minutes.
While the Ambulance Service’s record for meeting those targets is concerning, the figures for first responders are even more worrying: HIQA’s 70 percent first-responder target for ECHO calls was not met once between May 2014 and April 2015 in the west.
Figures released by the National Ambulance Service and HSE following a Freedom of Information request by Castlebar community activist Donal Geraghty reveal that between May 2014 and November 2014, not one urgent (ECHO) call was reached by a first responder in the recommended eight minutes. For less-urgent (DELTA) calls the figures are also extremely low – at zero percent for six months. The highest rate achieved in the 12-months between May 2014 and April 2015 was just 4.5 percent (in December 2014).

Ambulance times
For ECHO calls, the HIQA target was reached or exceeded by the Ambulance Service in the west in just six of the 12 months ended April 2015.
For DELTA calls, the number of casualties being reached within the 19-minute timeframe drops dramatically. October and December 2014 were the only months between May 2014 and April 2015 in which the timeframe standard was met at least 68 percent of the time - the guideline level from HIQA.
July 2014 was the worst month for ECHO response times, with just 37 percent of casualties being reached in under 19 minutes. The best month was October 2014, when 95 percent of ECHO calls were responded to in under 19 minutes.
For DELTA calls, December 2014 was the best month, with the Ambulance Service reaching casualties in 19 minutes or less 71.3 percent of the time. The worst month was July 2014, when just 44 percent of DELTA casualties were reached in under 19 minutes.

Rural county
In a rural county such as Mayo, meeting the HIQA timeframe guidelines for first responders and the Ambulance Service is still proving to be a huge challenge.
Depending on the month, ambulance response times fluctuate wildly, while first-responder response times are nowhere near the recommended level. March 2015 was the best month in this regard, when just 29.5 percent of ECHO calls were reached by a first responder within eight minutes – some 40 percent shy of the recommended target.

Regional statistics
These figures relate to all National Ambulance Service bases in the West region. Specific figures for Mayo are not available, with the National Ambulance Service stating that it reports percentage by region and not by station for its own staff first responders and patient-carrying vehicles.
The National Ambulance Service’s West region includes bases in Ballinasloe, Roscommon, Boyle, Loughrea, Galway, Carraroe, Clifden, Belmullet, Castlebar and Ballina, making Mayo-specific response times impossible to ascertain from the details provided.
The new ambulance base in Mulranny is also under the remit of the National Ambulance Service West region.
In the document seen by The Mayo News, the HSE confirms that the National Ambulance Service West does not have any community first responder schemes linked with the National Ambulance Service in Mayo. It states that each area of the National Ambulance Service has its own Major Emergency Plan and will call on the services of voluntary Ambulance Services (such as the Order of Malta) and the Civil Defence in the event of a major emergency.
Donal Geraghty contends that the poor first-responder times would be addressed by establishing appropriate community first-responder schemes in the county – a move that he believes would save lives. The document containing the above figures also reveals that the cost of a new ambulance is €128,048.