Ambulance turnaround times well short of targets

Ambulances spent more than 8,000 hours delayed at hospital emergency departments waiting to hand over patients during one month this year, previously unpublished records show.

The majority of paramedic crews across the State waited longer than the Health Service Executive’s target of 20 minutes to hand over patients, get their trolleys back and return to responding to calls.

The records, for April, were released to Independent TD Denis Naughten by the HSE's National Ambulance Service last week. They reveal that almost one in 10 ambulances was delayed for over an hour.

There were 16,333 ambulance attendances at the State’s 34 emergency departments in April and 9 per cent of them, or 1,407, spent more than an hour delayed outside, including 43 that spent from three to 14 hours.

This data indicates there has been no improvement since the end of last year in ambulance turnaround times at hospitals, despite the issue being identified by the HSE last December as one which would be a particular focus this year.

Delays at overcrowded emergency departments, formerly known as A&Es, have been singled out as a key obstacle to the HSE’s National Ambulance Service being able to address its failure to meet response time targets.

Series of deaths

Ambulance response times have come in for severe criticism in the past year following a series of deaths involving people who had been left waiting up to 45 minutes for an ambulance despite having been triaged by the NAS within 20 minutes.

These new figures, which for the first time give us a hospital-by-hospital breakdown of ambulance turnaround times, show the NAS continues to fall well short of its targets, with an average turnaround time across emergency departments of 29 minutes 57 seconds in April.

In 25 of the emergency departments, over half of all ambulances were delayed for more than 20 minutes. For instance, 89 per cent of ambulances arriving at Cork University Hospital were delayed over 20 minutes. Crews and patients endured the longest average waiting times here, at 47 minutes and 32 seconds, while 23 per cent had to wait more than an hour.

At Galway University Hospital, 80 per cent of ambulances were delayed over 20 minutes; in Mullingar 76 per cent were, while 75 per cent waited more than 20 minutes in South Tipperary General Hospital.

Hour-long delays

At others, significant numbers were waiting over an hour. At Portiuncula, Co Galway, for instance, almost one in five (19 per cent) ambulances were delayed for more than an hour, while 15 per cent waited over an hour at University Hospital Waterford and 13 per cent waited for the same period at Letterkenny General.

Mr Naughten said the figures underlined the need for a “significant investment in the ambulance service” and showed how the closure of smaller emergency departments was impacting on larger ones and the ambulance service.

The longest total delays were at Limerick Regional, described by the Health Information and Quality Authority last week as “not fit for purpose”.

Since the closure of emergency departments at Nenagh and Ennis in 2012, the annual trolley count at Limerick has increased from 3,626 in 2012 to 5,504 last year.

In April, ambulances spent 667 hours and 38 minutes parked outside it.

A spokeswoman for the HSE said: “The National Ambulance Service monitors hospital turnaround times on a continuous basis, and has an escalation policy which is implemented when required.”