Changes to ambulance services to commence March 2013
Current system: Clonakilty, Skibbereen, Castletownbere and Bantry
Monday to Thursday 8.00am to 8.00pm:
Four ambulances crews ‘on duty’.
Monday to Thursday 8.00pm to 8.00am:
Four ambulances crews available ‘on call’ i.e. ambulance crews are at home available to respond to an emergency call if required. Activation time from home to base is, on average across all rural stations, 21 minutes.
Monday to Friday 8 hours day time: One intermediate care vehicle.
Monday to Sunday 24/7: One rapid response vehicle.
New system from March 2013: Clonakilty (7am-7pm), Skibbereen (8am-8pm), Castletownbere (8am-8pm) and Bantry (7am-7pm).
Monday to Sunday (Day Time):
Four emergency ambulances and one rapid response vehicle on duty.
Monday to Sunday (Night Time)
Three emergency ambulances and one advanced paramedic emergency ambulance will be on duty.
Monday to Friday, (10am-6pm) except Mondays 11am-6pm
One intermediate care vehicle and the HSE has plans to extend this to a seven day service by September 2013.
The West Cork area will also be strategically supported by Cork city resources in addition to resources redeployed from South Kerry, given that traditional boundaries will now be eliminated, emergency resources will be moved to support surges in demand in any area.
A further development for West Cork is the availability of Emergency Aeromedical Service. Paramedics will have access to air support from the Air Corps, in clinically defined circumstances, for example a patient requiring specialist intervention within a specific timeframe. Ground emergency ambulances and helicopters will be able meet up at pre-designated landing zones around the West Cork region to transfer these patients to Cork University Hospital or Kerry General Hospital.
The new model of service being implemented in West Cork has been informed by the modernisation developments that have already taken place in East and North Cork.
Robert Morton, Director of the National Ambulance Service (and practicing Advanced Paramedic) said, “The HSE is confident that the modernisation of the National Ambulance Service (NAS) in Cork/Kerry has the potential to provide a world class pre-hospital emergency care service to the people of the area. People in West Cork will now have access to an ‘on duty’ service 24 hours a day, seven days a week with the appropriate personnel and fleet to best match this model of service.
“The intermediate care vehicles focus on the routine patient transfer work that previously used up to 30% of our emergency ambulance’s time / workload. In particular, the additional emergency ambulance capacity that has been freed up by the introduction of the new intermediate care vehicles provides further resources to improve our pre-hospital emergency care services to our patients. The Emergency Aeromedical Service will also make a positive contribution to patients in West Cork requiring transportation to Cork University Hospital or Kerry General Hospital and we are confident that this new emergency service will benefit specific patients such as those suffering heart attacks.”
Dr. Cathal O’Donnell, Medical Director of the National Ambulance Service and Consultant in Emergency Medicine said, “The emphasis in a modern emergency service is on highly trained health professionals that can perform life saving interventions at the scene of an emergency. The NAS has invested significantly in recent years in training ambulance staff to very high standards in both paramedic (2 years training) and advanced paramedic (an additional 2 years training). Both paramedics and advanced paramedics can provide a very high level of medical assessment and medical treatment, in many cases potentially life-saving treatment. The elimination of ‘on call’ in the region now sees the availability of emergency resources in the entire Cork area, 24 hours a day, seven days a week, ensuring people having equal and timely access to highly skilled paramedic and advanced paramedic staff day or night.”
Editors Notes:
Elimination of ‘on call’ work practice
The elimination of ‘on call’ work practice is a key element of a broader range of changes planned across the entire country including Cork and Kerry. Phase 1 of this element of the plan, focussed on the elimination of ‘on call’ for ambulance crews in East Cork; Youghal, Middleton and Fermoy Stations, Monday to Thursday, between 8.00pm and 8.00am. Phase 2 of this element of the plan, focussed on the elimination of ‘on call’ for ambulance crews in North Cork; Mallow, Millstreet, Kanturk and Macroom, Monday to Thursday, between 8.00pm and 8.00am. Both of these phases are now complete.
The ‘on call’ system sees crews available for work from their own homes (not working unless called in) predominantly for 999 emergency calls. The activation time from home to the ambulance station is, on average across all rural stations, 21 minutes. The new system will see the elimination of ‘on call’ with paramedics and advanced paramedics moving to a new work practice where they are rostered ‘on duty’ 24 hours a day, seven days a week, 365 days a year.
The ‘on duty’ resource will include a mix of emergency ambulances and rapid response vehicles which will be dynamically deployed i.e. strategically located where most likely to be required, rather than statically deployed i.e. located at a particular station.
HIQA standards
A significant factor in the broader reconfiguration plans is HIQA’s new Performance Standards, based on international evidence and experience, for life threatening and potentially life threatening emergency calls. “Life threatening” emergency calls account for less than 2% of all 999 calls while “potentially life threatening” emergency calls account for approximately 37% of all 999 calls. Approximately 60% of all 999 calls made to the NAS are neither life threatening nor potentially life threatening. Approximately 10% of all 999 calls to the NAS are inappropriate for an emergency ambulance. These statistics are consistent with international experience.
The new standards require a first responder to be on scene to a life threatening or potentially life threatening emergency within 8 minutes in 75% of cases and a transporting vehicle on scene to a life threatening and potentially life threatening emergency within 19 minutes in 80% of cases. In the context of these new Standards, it is clear that the ‘on call’ system of working is no longer fit for purpose.
Consultation process
The introduction of the new system requires the full co-operation of all staff. The HSE has completed a consultation process with staff at each ambulance station in West Cork on the HSE’s proposals in relation to the elimination of ‘on call’ and other associated changes. HSE South management and the NAS have also conducted an extensive consultation process with community leaders e.g. GPs and other health professionals, public representatives, community groups, etc. with a view to providing as much clarity as possible on the changes to come and to assuage any public concerns that may exist. The outcome of this consultation exercise has informed the final shape of the HSE’s plan for Phase 3 of Modernisation of the National Ambulance Service in Cork/Kerry.
Monday to Thursday 8.00am to 8.00pm:
Four ambulances crews ‘on duty’.
Monday to Thursday 8.00pm to 8.00am:
Four ambulances crews available ‘on call’ i.e. ambulance crews are at home available to respond to an emergency call if required. Activation time from home to base is, on average across all rural stations, 21 minutes.
Monday to Friday 8 hours day time: One intermediate care vehicle.
Monday to Sunday 24/7: One rapid response vehicle.
New system from March 2013: Clonakilty (7am-7pm), Skibbereen (8am-8pm), Castletownbere (8am-8pm) and Bantry (7am-7pm).
Monday to Sunday (Day Time):
Four emergency ambulances and one rapid response vehicle on duty.
Monday to Sunday (Night Time)
Three emergency ambulances and one advanced paramedic emergency ambulance will be on duty.
Monday to Friday, (10am-6pm) except Mondays 11am-6pm
One intermediate care vehicle and the HSE has plans to extend this to a seven day service by September 2013.
The West Cork area will also be strategically supported by Cork city resources in addition to resources redeployed from South Kerry, given that traditional boundaries will now be eliminated, emergency resources will be moved to support surges in demand in any area.
A further development for West Cork is the availability of Emergency Aeromedical Service. Paramedics will have access to air support from the Air Corps, in clinically defined circumstances, for example a patient requiring specialist intervention within a specific timeframe. Ground emergency ambulances and helicopters will be able meet up at pre-designated landing zones around the West Cork region to transfer these patients to Cork University Hospital or Kerry General Hospital.
The new model of service being implemented in West Cork has been informed by the modernisation developments that have already taken place in East and North Cork.
Robert Morton, Director of the National Ambulance Service (and practicing Advanced Paramedic) said, “The HSE is confident that the modernisation of the National Ambulance Service (NAS) in Cork/Kerry has the potential to provide a world class pre-hospital emergency care service to the people of the area. People in West Cork will now have access to an ‘on duty’ service 24 hours a day, seven days a week with the appropriate personnel and fleet to best match this model of service.
“The intermediate care vehicles focus on the routine patient transfer work that previously used up to 30% of our emergency ambulance’s time / workload. In particular, the additional emergency ambulance capacity that has been freed up by the introduction of the new intermediate care vehicles provides further resources to improve our pre-hospital emergency care services to our patients. The Emergency Aeromedical Service will also make a positive contribution to patients in West Cork requiring transportation to Cork University Hospital or Kerry General Hospital and we are confident that this new emergency service will benefit specific patients such as those suffering heart attacks.”
Dr. Cathal O’Donnell, Medical Director of the National Ambulance Service and Consultant in Emergency Medicine said, “The emphasis in a modern emergency service is on highly trained health professionals that can perform life saving interventions at the scene of an emergency. The NAS has invested significantly in recent years in training ambulance staff to very high standards in both paramedic (2 years training) and advanced paramedic (an additional 2 years training). Both paramedics and advanced paramedics can provide a very high level of medical assessment and medical treatment, in many cases potentially life-saving treatment. The elimination of ‘on call’ in the region now sees the availability of emergency resources in the entire Cork area, 24 hours a day, seven days a week, ensuring people having equal and timely access to highly skilled paramedic and advanced paramedic staff day or night.”
Editors Notes:
Elimination of ‘on call’ work practice
The elimination of ‘on call’ work practice is a key element of a broader range of changes planned across the entire country including Cork and Kerry. Phase 1 of this element of the plan, focussed on the elimination of ‘on call’ for ambulance crews in East Cork; Youghal, Middleton and Fermoy Stations, Monday to Thursday, between 8.00pm and 8.00am. Phase 2 of this element of the plan, focussed on the elimination of ‘on call’ for ambulance crews in North Cork; Mallow, Millstreet, Kanturk and Macroom, Monday to Thursday, between 8.00pm and 8.00am. Both of these phases are now complete.
The ‘on call’ system sees crews available for work from their own homes (not working unless called in) predominantly for 999 emergency calls. The activation time from home to the ambulance station is, on average across all rural stations, 21 minutes. The new system will see the elimination of ‘on call’ with paramedics and advanced paramedics moving to a new work practice where they are rostered ‘on duty’ 24 hours a day, seven days a week, 365 days a year.
The ‘on duty’ resource will include a mix of emergency ambulances and rapid response vehicles which will be dynamically deployed i.e. strategically located where most likely to be required, rather than statically deployed i.e. located at a particular station.
HIQA standards
A significant factor in the broader reconfiguration plans is HIQA’s new Performance Standards, based on international evidence and experience, for life threatening and potentially life threatening emergency calls. “Life threatening” emergency calls account for less than 2% of all 999 calls while “potentially life threatening” emergency calls account for approximately 37% of all 999 calls. Approximately 60% of all 999 calls made to the NAS are neither life threatening nor potentially life threatening. Approximately 10% of all 999 calls to the NAS are inappropriate for an emergency ambulance. These statistics are consistent with international experience.
The new standards require a first responder to be on scene to a life threatening or potentially life threatening emergency within 8 minutes in 75% of cases and a transporting vehicle on scene to a life threatening and potentially life threatening emergency within 19 minutes in 80% of cases. In the context of these new Standards, it is clear that the ‘on call’ system of working is no longer fit for purpose.
Consultation process
The introduction of the new system requires the full co-operation of all staff. The HSE has completed a consultation process with staff at each ambulance station in West Cork on the HSE’s proposals in relation to the elimination of ‘on call’ and other associated changes. HSE South management and the NAS have also conducted an extensive consultation process with community leaders e.g. GPs and other health professionals, public representatives, community groups, etc. with a view to providing as much clarity as possible on the changes to come and to assuage any public concerns that may exist. The outcome of this consultation exercise has informed the final shape of the HSE’s plan for Phase 3 of Modernisation of the National Ambulance Service in Cork/Kerry.
