Ms Laverne McGuinness:

That is what I said. I stated it had made specific reference in this regard. It stated "some staff reported that while they had accepted a new position within the Service, they did not have the requisite technical knowledge for the particular post". Consequently, we specifically asked in respect of senior management because approximately six posts were replaced in the past 12 to 18 months, all of which went through a competitive process. There was a specific job description for these posts and Mr. Martin Dunne again met his senior team on an individual basis to ascertain whether any of the team members had particular skill deficits that they thought needed to be addressed. I also asked HIQA whether it could identify this but because of confidentiality issues, it could not do so. Notwithstanding this, we are certainly not leaving it lie at that. As the joint committee is aware, a management capacity review has been commissioned to examine what is the appropriate organisational structure for the management of ambulance services and all job descriptions will also be reviewed in that light. We are certainly not taking this issue lightly and are giving it significant consideration.

As for the issue of clinical audit, while the medical director of the national ambulance service, Dr. Cathal O'Donnell, will speak about it, we are measuring clinical outcomes. We started doing so in the third quarter and it takes some time to put it in place. One key outcome we are measuring is return of spontaneous circulation. We are reporting and achieving a rate of 39% against a best international rate of 40%. There is much more work to be done in the clinical area and clinical audit, but Dr. O'Donnell may wish to speak on the subject.