Dr. Cathal O'Donnell:

Yes. Ms Laverne McGuinness has mentioned the single clinical outcome indicator that we have implemented in recent months; it is called return of spontaneous circulation. If someone has a cardiac arrest in which his or her heart stops and if we, as a service, that is, the paramedics, can restart his or her heart beating by the time we get to the emergency department, we are measuring this against the total number of cardiac arrests attended to and will report it. Separately last year, in conjunction with the Pre-Hospital Emergency Care Council, we commissioned an academic piece of work to identify a set of clinical outcome indicators that would be suitable for pre-hospital care in this country. That process is now complete and we have a menu or suite of more than 100 clinical outcome indicators that have been identified through an academic process as being suitable for use by us or any other ambulance service in Ireland. When we receive a methodology - either the scanning solution or, I hope in the longer term, the electronic patient care report, ECPR - we will have both the technology and meaningful clinical outcome indicators.

To conclude by referring to response times, ultimately, a response time is a very crude measure of the performance of an ambulance service. All it measures is how fast one will get there. I am a doctor and much more interested in how the patient is when we get there and doing what we must do. I suggest clinical outcome indicators are a much better measure.