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Monday, 28 February, 2000, 19:55 GMT
Ambulance response times under review
A review of Northern Ireland's ambulance service has recommended faster response times to 999 calls and improved training of ambulance personnel.
A report based on the review recommends measures to help the service hit the target that crews will reach 75% three quarters of all life threatening calls within eight minutes by the end of 2005.
Currently approximately half of emergency calls to the service are answered within that time.
The report on the Strategic Review of the Ambulance Service carried out by health board representatives, general practitioners, clinicians and ambulance service chiefs, contains a total of 71 recommendations which have been published for public consultation.
The measures recommended include the better location of ambulance vehicles and crews, upgrading the communications systems, the introduction of new rapid response vehicles and better call prioritisation by the introduction of a Priority Dispatch System.
One major proposal is centralising the four ambulance control rooms to one centre.
Northern Ireland currently has an ambulance control room in each of the four health board areas.
Ambulance personnel, both on the ground and in the control room should be given better training, the report recommends.
Control room staff need to learn how to better prioritise 999 emergency calls and ways of improving clinical development and education of paramedics in the field should be identified, the report said.
The training of police, fire and coastguard personnel in advanced first aid and defibrillation skills to allow them to act as co-responders to emergency call-outs should be considered, it added.
The report also recommends separating the 999 blue flashing light ambulances from the non-emergency patient carrying fleet.
Responsibility for the specification, commissioning and monitoring of patient care services should be transferred to the health Trusts and general practitioners, it said.
Extra ambulance stations
The report also proposes identifying 20 extra locations in the province where ambulances and crews should be located and said in some areas better response times could be achieved by a system of "dynamic standby" - siting crews at points historically proven to have a high incidence of calls.
Consideration should also be given to having ambulances or single paramedics patrolling specific geographic zones, responding only to life-threatening calls as they occur.
A cross border working group should be set up to address areas of co-operation between ambulance services in border areas of Northern Ireland and the Republic Of Ireland to ensure "seamless emergency ambulance care right along the border".
And the service should also work towards closer collaboration with the fire and police services, the report added
The review's findings have been published just a month after it was completed.
The speed is an indication of how serious the Department of Health is about moving ahead with the hospital closure programme.
The closures of small and rural hospitals as acute services are centralised to six major hospital sites will have major implications for the ambulance service.
Many of the review recommendations would be expensive to implement, but the report does no speculate about where the money should come from.
The decisions on how to balance the competing needs within Northern Ireland's health service have been given back to the Northern Ireland office following the suspension of Northern Ireland devolution.
Welcoming the publication, a spokesman for the Department of Health, Social Services and Public Safety said: "This is a comprehensive report with many far-reaching proposals to improve the efficiency and effectiveness of ambulance services.
"There will be a great deal of interest throughout the province in the performance targets proposed and the measures recommended to achieve them."
Tom Frawley, general manager of Northern Ireland's Western Health Board, who chaired the review, said for the past 30 years the ambulance service had made an outstanding contribution, often in demanding and difficult circumstances.
But he said: "What may have served us well in the past is no longer appropriate for the future.
"Change is required, and the report's recommendations are aimed not only at bringing about changes that will create an ambulance service for the future, but at attaining that vision through a controlled, phased approach."
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