Ms Laverne McGuinness:

I thank members for the invitation to attend this meeting to discuss the recently published Health Information and Quality Authority, HIQA, review of pre-hospital emergency care services and the Health Service Executive's initial response to the report's findings and recommendations. I have provided a detailed briefing note on the national ambulance service and its transformation programme. I have also circulated a copy of the executive summary and recommendations of the national capacity review, an independent, external report commissioned by the HSE. I will, therefore, focus on a number of the key areas highlighted in HIQA's report.
The Health Information and Quality Authority's review of pre-hospital emergency care services acknowledges that a lot of progress has been made by the national ambulance service in recent years. The acknowledgement by HIQA of the significant role played by the ambulance service in improving patient outcomes in the areas of stroke and acute coronary care is particularly noteworthy. The report also identifies a range of challenges for the future improvement of services under headings already identified by the HSE as requiring attention. The 12 recommendations made by HIQA are being implemented or will be incorporated into the planned programme to improve ambulance services.
The working and governance arrangements of the national ambulance service and Dublin fire brigade are discussed in the report. Both organisations will work collaboratively in the implementation of the recommendations set out in HIQA's report. In advance of the outcome of the joint review of the Dublin fire brigade, early engagement will take place at corporate and operational levels and between the medical directors of each service on the establishment of a formal link in the area of medical assurance.
To develop a modern and improved ambulance service, the national ambulance service commenced a significant change programme in 2012 which identified the need for changed and improved work practices and investment in infrastructure, information technology and the ambulance fleet. Ten key strategic objectives were identified as necessary to meet the growing needs and demands of the service.

These are: implementing national control centre reconfiguration; undertaking a national ambulance service capacity review; implementing the response times improvement framework; engagement with patients and families; reviewing the provision of emergency ambulance services in Dublin city and county - the Dublin fire brigade review; developing and implementing the electronic patient care record; developing and implementing clinical performance measures; developing and implementing a clinical audit programme; expanding the community first responder scheme; and developing options to move to a BSc model of education for paramedics.

To give effect to this programme of change, significant investment has been made in the ambulance service at a time when other parts of the health service have experienced significant budget reductions. Some €26.2 million has been invested in the national ambulance service in 2013 and 2014 in the development of the national control centre and the related information and communications technology, including computer-aided dispatch. A further €11.5 million was allocated in 2014 - as part of the fleet maintenance programme - for the purchase of 36 new emergency ambulances and two critical care ambulances, as well as 180 new defibrillators and 20 mechanical resuscitation devices. A sum of €5.4 million will be allocated in 2015 for the purpose of putting in place a range of developments, including the opening and staffing of ambulance stations at Lough Lynn, Mulranny and Tuam, the completion of the national control centre, a clinical audit and the elimination of on-call services in the west. In 2015, €7.5 million will also be allocated for the purchase of 47 brand new ambulances.