Dr. Cathal O'Donnell:

I do not have a huge amount to add. I think Mr. Morton has covered it very well. We target all of these at low-acuity calls. In particular, we are interested in the frail elderly because much the time patients would be better served by not going to a busy emergency department and they do not tolerate some of the delays we see in emergency departments well. In particular, the community paramedicine programme, the Pathfinder programme and what is called the alternative pathway programme in Cork are now transitioning from projects where we were testing the safety and effectiveness of them and we are now mainstreaming them. Pathfinder is a good example of that. It is a collaboration with Beaumont Hospital whereby we put an advanced paramedic and either a physiotherapist or an occupational therapist in a vehicle and they respond to low-acuity calls from the frail elderly. This has been so successful that we are looking at expanding it to eight further locations throughout the country.

One thing Mr. Morton did not mention that will also have an impact is the fact that the Pre-Hospital Emergency Care Council has finalised and released treat and refer clinical practice guidelines. The important thing about those is that they will apply to every single paramedic in the NAS and Dublin Fire Brigade and will allow paramedics to safely assess and not transport someone as per protocol.