Denis Naughten (Roscommon-South Leitrim, Independent)
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To ask the Minister for Health his plans to improve ambulance coverage and response times throughout County Roscommon and East Galway; and if he will make a statement on the matter. [7433/13]

James Reilly (Dublin North, Fine Gael)
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Nationally co-ordinated pre-hospital emergency care is provided by the HSE National Ambulance Service (NAS). Pre-hospital emergency care supports wider healthcare reform such as the reorganisation of acute care provision, including the Small Hospitals Framework, and implementation of the clinical care programmes.

The Health Information and Quality Authority has developed a set of key performance indicators (KPIs), which classify 999 emergency calls by clinical status. Clinical Status 1 Echo calls involve life-threatening emergencies of cardiac or respiratory origin. Clinical Status 1 Delta calls involve life-threatening emergencies of other than cardiac or respiratory origin. The target times for responding to Echo 1 and Delta 1 calls are 7 minutes 59 seconds by a first responder (a person trained in minimum basic life support and use of a defibrillator) and 18 minutes 59 seconds for a patient-carrying vehicle. With effect from January 2012, HIQA set the target for first responders to meet the response time (7 minutes 59 seconds) in 75% of cases. From January 2013 the target for patient-carrying vehicles is to meet the Clinical Status 1 ECHO incidents response time (18 minutes 59 seconds) in 85% of cases.

Following a review of the validity of time-based KPIs for clinical status data, and in line with international views, it is considered that clinical outcome indicators would be more appropriate, and work has begun on their development. I also welcome the consequential outcome that use of clinical indicators will enable a focus on Clinical Status 1 (Echo and Delta) calls.

The NAS has been taking a number of steps to improve response times. These include development of a Performance Improvement Action Plan, an intermediate care service, the control centre reconfiguration project and a trial emergency aeromedical service. Following a referral to the Labour Court under the Public Service Agreement, the NAS is progressing a number of efficiencies arising from the Court's recommendations, including the issue of overtime built in to rosters. New rosters are now in place and are operating successfully.

Through its control centre reconfiguration project, the NAS is continuing to rationalise the number of ambulance control rooms across the country, with a target of one system across 2 sites - Tallaght and Ballyshannon. The current total is nine. This project is focused on improving call taking and dispatch functions and on delivering improved technology. This will assist in improving response times and will allow the NAS to deploy resources in a much more effective and efficient manner, on a regional and national basis rather than within small geographic areas.

The Emergency Aeromedical Service (EAS) was initiated as a 12 month trial in June 2012, with two purposes - to reduce the transit time to an appropriate facility for certain conditions, particularly in the West, and to determine the extent, if any, of the need for aeromedical support to the NAS and, if required, how best to provide it. The trial involves the Irish Air Corps providing aeromedical support to the HSE NAS, from a base in Custume Barracks, Athlone. The aircraft is operated by the Air Corps, with clinical staffing from the NAS. The Irish Coast Guard also provides additional support to the primary aircraft, using its new search and rescue helicopter in Shannon, staffed by its own paramedics and an NAS advanced paramedic when necessary.

The NAS is developing non-emergency transport, through a national intermediate care service (ICS), which is key to resolving bed and clinical management pressures. ICS will allow for safe, planned and timely clinical transfers of inpatients to the most appropriate facility, depending on their acuity and clinical needs. This will allow for beds to be made available for higher acuity admissions through emergency departments. ICS will also release emergency resources for emergency functions, for improved response times and performances in pre-hospital care. To date, ICS has been implemented in Cavan, Castleblayney, South County Dublin, Letterkenny, Sligo, Galway, Limerick, Roscommon, Mallow and Bantry. Supported by the 2013 National Service Plan, the NAS intends to expand ICS to Waterford, Cork, Tralee, Castlebar and Drogheda and to increase services in Dublin and Galway during 2013.

The NAS, with the Retrieval and Transport Medicine Programme, will also use these additional services to support the Critical Care Programme, through the establishment and extension of critical care retrieval services.