Martin Daly probes regional ambulance response and turnaround times
Martin Daly questioned emergency services officials about ambulance response and turnaround times in the West-Northwest, focusing on Roscommon, Galway and Castlebar, and asked whether these areas differ from the national average. He pressed officials on causes of delay — staffing, hospital handover and rising job cycle times — and requested local figures.
The director referenced national targets for life‑threatening calls, noting a 75% response within 18 minutes for Purple calls and a 45% target for Red calls. He said West‑Northwest figures are generally marginally above the national average, though there is considerable variation across the country.
Officials acknowledged marked variation in response and turnaround times between regions, and said that an independent capacity review in 2022 had identified where those differences occur. The West‑Northwest was described as relatively better positioned in some measures compared with other areas when the totality of the data is examined.
Speakers attributed increased job cycle time to multiple factors: crews spending more time on scene delivering higher levels of care, new infection prevention and control guidance, longer handovers at emergency departments and, in some cases, longer journeys. The average job cycle time, which used to be one to one and a half hours, is now described as bouncing up to two hours per incident.
Limerick was identified as having the fastest turnaround time in the country. Officials said better collaboration between hospitals and the National Ambulance Service, clear KPIs and local trials such as dedicated staff known as HALs had shown promise as measures to reduce delays and are being reconsidered with REOs and management.
Martin Daly asked for specific figures for Roscommon, Galway and the West‑Northwest and was told the requested data could be provided directly. Concerns were raised in the debate about reports of four to five hour turnaround times at Castlebar Hospital and how those delays affect surrounding areas, prompting calls for targeted investment and system‑wide work on turnaround times.
Regional response targets and performance
The director referenced national targets for life‑threatening calls, noting a 75% response within 18 minutes for Purple calls and a 45% target for Red calls. He said West‑Northwest figures are generally marginally above the national average, though there is considerable variation across the country.
Variation across the country
Officials acknowledged marked variation in response and turnaround times between regions, and said that an independent capacity review in 2022 had identified where those differences occur. The West‑Northwest was described as relatively better positioned in some measures compared with other areas when the totality of the data is examined.
Causes of longer job cycle and turnaround
Speakers attributed increased job cycle time to multiple factors: crews spending more time on scene delivering higher levels of care, new infection prevention and control guidance, longer handovers at emergency departments and, in some cases, longer journeys. The average job cycle time, which used to be one to one and a half hours, is now described as bouncing up to two hours per incident.
Comparisons and lessons from faster areas
Limerick was identified as having the fastest turnaround time in the country. Officials said better collaboration between hospitals and the National Ambulance Service, clear KPIs and local trials such as dedicated staff known as HALs had shown promise as measures to reduce delays and are being reconsidered with REOs and management.
Requests for local figures and follow‑up
Martin Daly asked for specific figures for Roscommon, Galway and the West‑Northwest and was told the requested data could be provided directly. Concerns were raised in the debate about reports of four to five hour turnaround times at Castlebar Hospital and how those delays affect surrounding areas, prompting calls for targeted investment and system‑wide work on turnaround times.
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Transcript
From Deputy Coran's questions in relation to Roscommon. I looked at the response times nationally here and the purple life-threatening cardiac respiratory arrest response 75% to such calls within 18 minutes and a target of 45% for the Reds. But it appears that there may be variation nationally. And I'd just like to know, are there figures for the Roscommon, Galway and West-Northwest areas in terms of response times and how do they vary with the national average? That's the director just to cover that. Yeah, thanks, Deputy. So in relation to West-Northwest, the figures would generally be marginally above the national average. But you're right, there is variation across the country, considerable variation. Where the variation is was identified and pointed out to us in our independent capacity review in 2022. So a lot of any new staff investment that we get has obviously been targeted at those areas. But overall, there is considerable variation. And is the variation due to staffing, say, in, say, the Roscommon-Galway area or is it to do with turnaround times at hospitals? It's a combination of all, actually. If you think overall, one of the things we look at every day internally is called the job cycle time. And what that essentially is, is it's all of the moving parts of a single 9-9 call together. The average job cycle time used to be one, one and a half hours. It's now bouncing up to two hours per incident. Now, that's a conglomeration of issues. That's the amount of time the crews are spending on scene because they're delivering a higher level of care. It is new infection prevention and control guidelines. It is the time that it takes to hand over at the emergency department. And in some cases, it's actually the journey time. So it's an overall aggregate. What we're seeing overall is we're requiring more resource for every call and we are receiving more calls. But I've been told that four to five-hour turnaround time for Castlebar Hospital for anything. I mean, that's pretty unacceptable, isn't it? And that affects a region that extends down into Roscombe and East Coral. Yeah, well, and I think that's one of the issues. And it's not just in the West. It happens in... But you have agreed that the West is... It's a particular issue in the West of Ireland, in West-Northwest. Well, what I talked about earlier was that the turnaround times, like the significant work has to be done across our system on turnaround times. But the West-Northwest compared to the rest of the country. You did concede in my first question. Yeah, there's work to be done there. And I didn't get time to expand on it. Yeah, there's work to be done there. But what variation is there? Is it a significant variation or is there a marginal variation? Well, if you look at Little Kenny, it's... Well, I'm talking... You say Mayo, Galway, Roscommon area. It's what? It's 60-plus minutes in... So Galway would be closer to the national average. Castlebar would be above the national average in terms of the overall time. There would be overall variation, as Pat has touched on. Limerick is by far the fastest turnaround time in the country. Others are probably 10 minutes above the national average. And what lessons could we learn from Limerick that could be applied to Castlebar, to Galway, to... There's two things there that's important. One is the collaboration between... So what I said earlier was that we've set out the KPIs for both the hospital and NAS, and they have to work collaboratively. So I think where they're doing that, well, it's reflected in the performance times. I also said, and we're working with the REOs closely on this, that there was learning, and I think the CEO mentioned it in his last visit here, that we did a trial previously of HALs, as they were called. So, you know, dedicated staff who work to try and deal with the issues that are giving rise to delays. We did that previously in a number of areas. There was trials that seemed to be... It seemed to be something that worked well, and we're looking at that now with the REOs and ourselves to see how might we deploy that possibly. Just finally, the response times for Purple and Red, I just noticed a paragraph here that says, if you miss the target time, you could be waiting for one to two hours, and these are life-threatening situations. Are there a variation nationally, again, for Ruscom and Galway, West-Northwest region? Are we suffering there because we don't have those resources? No. So there's no variation for Galway, Ruscom and the rest of the... I think what the Director's been saying is that, actually, the West-Northwest is probably doing relatively better, and is probably relatively better resourced in that sense, in answer to Deputy Boyle, who was saying, look, it may not feel like that, but actually, when you look at the totality and the data and the stats that we have, the West-Northwest is probably in a better position relative to others. Would it be possible to get figures on that, please, directly to me, please? Thank you. Thanks very much.