Mr. Phelim Quinn:

A couple of specific issues have been raised. Two Deputies raised the substantive issue of appointing managers who do not have technical skills. I assure them that our description referred mainly to the senior management staff of the National Ambulance Service whom we interviewed. They reported to us that they had been appointed mainly through internal movement within the service and, at times, without appropriate job descriptions matched to the strategy of the National Ambulance Service. On a couple of occasions they also reported to us that they believed they had been appointed to senior management positions without the relevant technical skills. I do not want it reflected here that specific on the ground the staff or middle managers had reflected they were inappropriately appointed on the basis of the possession of technical skills. It was senior management staff, in the main, who had reported that particular deficit. The deficit is important and key because such staff are charged with strategically leading and operationally managing the service. The range of deficits and challenges that we found are very complex and require technical skills to achieve positive outcomes for the service and for service users.

Recommendation No. 6 highlights our other recommendations to extend the role of paramedic staff and advanced paramedic staff. We believe, at the minute, that there is not a sufficient number of advanced paramedic staff working in the services that would allow them to expand into a wider scope of practice. We have also unearthed, through the course of the review, the fact that a number of paramedical staff have left the service but have not been replaced in an appropriate way. There are issues with workforce planning and development to meet the needs of an emergent service.