Centralised approach aims to improve service

A press conference last December dealt with the independent review of the National Ambulance Service response to the Vakaris Martinaitis tragedy in Midleton, Co Cork.

The 23-month-old child died of severe head injuries after falling from an upstairs window at the family home in Midleton in May last year. An ambulance en route was stood down as the despatcher believed the boy had simply fallen in the garden, rather than having fallen into the garden.

NAS director Martin Dunne was asked at the press conference about the problem of ambulances going to the wrong addresses.

“We’ve updated all our mapping systems and are continuing to update them to the latest available,” he said. “The vehicles have locater systems which will locate them to within 50m while we will also be introducing digital radio technology.”

Mr Dunne said that as a result of the changes and the investment in the latest technology, he would be “very, very confident that we won’t have ambulances going to the wrong locations ever again” – a clear acknowledgement that this had been a problem for the service.

While there may have been problems with ambulances going to wrong addresses in the past, the problem seems to have become exacerbated, or at least is highlighted more, over the last year as the NAS is reconfigured. It is now moving from a service with 13 control centres to one control centre at two sites.

One national centre

In January, Laverne McGuinness of the HSE told an Oireachtas

Committee on Health that the move to one national operations centre would enable control staff to monitor every single ambulance in the service so the ambulance nearest the scene could be dispatched.

Calls are currently taken by the Emergency Call Answering Service operated by BT, where the caller is asked for the particular emergency service and their location before the call, in the case of medical emergencies, is transferred to the relevant ambulance control centre.

There are currently six ambulance control centres, at Tullamore, Wexford, Castlebar, Limerick, Ballyshannon and at Townsend Street in Dublin.

However, it is planned to centralise all operations by 2015 at a new national ambulance control centre operating at Tallaght, Dublin, and Ballyshannon, Co Donegal.

According to the HSE, the new set-up will ensure a single contact point for all 112/999 calls and will reduce the potential for error regarding boundaries and areas, which in the past have not always led to the nearest available ambulance being dispatched to an incident.

For many public representatives, though, the centralisation of control and dispatch has led to concerns about a lack of local knowledge and the impact that can have.

The closure of the Tralee centre has caused particular concern in Kerry amid a series of blunders in the county.

Last May, an ambulance was sent to Clohane near Castlegregory in west Kerry rather than to Clahane near Ballyduff in north Kerry, while there was also a mix-up a week earlier which led to an ambulance going to Listowel in north Kerry rather than Lispole in west Kerry.

A month later, an ambulance was dispatched to the tennis village in Bishopstown in Cork city rather than the tennis village in Tralee to attend to three- week-old Morfeusz Chlamtacz, who had died in a suspected cot death.

As recently as February 9th, a case in Cork city gave rise to grave concern when an ECAS call taker was not able to identify St Patrick’s Bridge or St Patrick’s Street – the city’s main street – after a member of the public rang in to say there was a person in the river near St Patrick’s Bridge.

Such experiences as the Kerry cases have led to calls for ambulances to be fitted with sat- navs. However, Minister for Health James Reilly said in January that ambulances were not fitted with sat-navs as they were "not sufficiently safe and do not contain maps with Irish townlands".

Dr Reilly told the Oireachtas Committee on Health that the NAS operated GeoDirectory mapping combined with digital automatic vehicle location which allowed NAS control to direct a vehicle to the scene of an incident.

Joint mapping project
GeoDirectory Ireland was jointly established by An Post and the Ordinance Survey of Ireland to create and manage a database of all 1.8 million buildings in the Republic, each of which is given a unique eight- figure ID code which should make them easy to locate.

According to the HSE, the address details are entered into the computer-aided dispatch system which is linked to Ordinance Survey Mapping. It has the GeoDirectory Ireland as an address database so that the dispatch system can identify the nearest available ambulance.

However, as Dr Reilly acknowledged to the health committee, sometimes wrong information may be given – or may have been misunderstood or misheard as appears to have happened in the Kerry cases – and vehicles can be directed to the wrong location.