Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I welcome the opportunity to address this House on behalf of the Minister, Deputy Donnelly, regarding the Senator’s request for information relating to physician-led helicopter emergency medical services, HEMS, in Ireland. I was sitting in the Dáil yesterday when Deputy Berry, who is also a medical doctor, raised this issue with the Taoiseach. It was a positive engagement. One of the requests he made was that the Taoiseach would engage with those physicians mentioned by the Senator and the Taoiseach responded by saying he would. Everybody was delighted to hear that answer, that we are progressing in this regard and that we are going to have the pilot scheme.

Just to be clear, it is important to note that the HSE's National Ambulance Service, NAS, currently provides two consultant-led, paramedic-delivered, dedicated HEMS responses in Ireland. I will briefly outline what this entails. The emergency aeromedical service, EAS, operates in conjunction with the Air Corps from Custume Barracks in Athlone and predominantly serves the west and north west. The south-west HEMS response, a publicly-funded service operated by the NAS in conjunction with a commercial operator, serves the south and south west. In addition to these dedicated services, the Irish Coast Guard provides further HEMS support from its four bases in Shannon, Sligo, Waterford and Dublin on an as-available basis. It does phenomenal work. HEMS in Ireland provide fast access to lifesaving pre-hospital emergency care interventions at the scene by highly-trained advanced paramedics. HEMS is also used to rapidly transport patients to the hospital with the specialist facilities and treatments best suited to their lifesaving needs. This may not always be the closest available hospital.

All HEMS aircraft are tasked through the 999-112 emergency system by a specialist aeromedical co-ordinator in the NAS National Emergency Operations Centre, NEOC. Last year, HEMS services attended 904 incidents in Ireland and such deployments have greatly reduced scene-to-hospital times, particularly in more rural parts of the country. We often think about road traffic accidents in this context, but there are many accidents in farms and around our lovely mountains and lakes that equally make this service important.

On the question of HEMS in Ireland being physician-led, I confirm that the overall delivery of HEMS services in Ireland is consultant-led but the service is delivered by highly-trained advanced paramedics. Clinician-crewing models for HEMS can vary across jurisdictions, with various configurations including paramedic-only, paramedic-physician- and paramedic-nurse-delivered services. In Ireland, HEMS is primarily focused on providing rapid access for patients to the most appropriate clinical care. This is particularly important due to Ireland’s remote and dispersed population. The provision of HEMS ensures equity of access to care for acutely ill and injured patients. The national trauma strategy acknowledges the importance of HEMS in Ireland as being a vital part of the pre-hospital care and retrieval stage of the trauma system, as the Senator mentioned.

The important point to be made here is that the NAS is due to commence a feasibility study next month which will see, on a trial basis, the deployment of physicians as part of its HEMS responses. The trial is expected to last approximately four months. As part of the study, NAS-affiliated emergency medicine consultants, with considerable experience in pre-hospital emergency medicine, will undertake a number of rotations each week on HEMS aircraft alongside NAS advanced paramedics. During this trial, key metrics and outcomes, such as the types of interventions performed by each physician on the scene and average on-scene time, will be measured.