Dr. Mike O'Connor:

I commend the National Ambulance Service and Dublin Fire Brigade on their professional and highly trained nature. They are a pleasure to work with in the HSE. I absolutely double down on the concerns about those handover delays. Mr. Robert Morton who is the head of ambulance service reckons that at any one time there is 137 WTEs lost by having patients waiting at the front of hospitals. It is the most visible effect of people being in the wrong place at various stages in our hospitals and one can drive by a hospital and know there is congestion inside the emergency department by how many ambulances are outside. We convened a group between the National Ambulance Service and HSE acute operations in August. We will do a learning piece in early December about what we can learn from rapid improvement cycles to improve this quite dramatically. The CEO mentioned two of them which was cohorting, when one ambulance crew takes a second patient to free up an ambulance and the fit to sit campaign where patients do not necessarily have to go into a cubicle. There is a body of work being done on this mainly because it is a problem and, second, because the problem is growing, with the handover delays growing as we have gone through 2022.