1. National Ambulance Service (NAS) Martin Dunne Director NAS

2. NAS
2000 Staff
1 National Emergency Operations Centre (NEOC) across 2 sites (Tallaght and Ballyshannon)
102 Locations
500 Vehicles
Financial Envelope is circa €200m
North Leinster
Population: 4,809,419
Area: 68,890 sq.Km (26,592 square miles)
The primary & secondary road network in Ireland
is some 5,306km long and is made up of motorways,
dual carriageways & single lane roads
320,000 Ambulance Calls per annum
Average 1000 calls per day
22m km Per annum by Road

3. NAS Service Evolution 2006 to 2017
Ambulance Service National Ambulance Service 2017
Basic Life Support
Basic and Advanced Life Support; Community Paramedicine
11 Individual Control Centres
Single National Emergency Operations Centre across 2 sites
Emergency Medical Technician- 5 drugs
Emergency Medical Technician -13 meds
Paramedic meds
Advanced Paramedic meds
Community Paramedic plus
Limited medications
Limited equipment
Expanded range of patient monitoring devices
Expanded range of patient management devices
Expanded range of medications
Equipment List for each vehicle type
Patient Intervention
Service
People Competency
Patient Care Equipment

4. NAS Service Evolution 2006 to 2017
Emergency Ambulance Service
Intermediate Care Service
Rapid Response Vehicle, Motorbike Response Units,
Aero Medical Service
Critical Care Retrieval Service
Emergency Ambulance Service
Patient Transport Service
Operations
Fleet
Aged Profile varied
Varied Specifications
No replacement plans
Best Practice Procurement & Replacement Policy
Standard Specification
Modern Fleet – Use of Green Technology
Major estate upgrade commenced
New Ambulance bases
Deployment Points been developed in line with New Primary Care Centre Builds
Estate
Overcrowded due to increased staffing
Requires significant development
Limited ICT
Limited connectivity to control
Varied Specifications
Technology
Modern integrated CAS system
Modern Digital Communications System

5. Live Performance Management (SFN)
Where We Are Now
Live Performance Management (SFN)

7. The future………………………

8. Future Model of Care
Emergency Medical Service (EMS) to Mobile Medical Service (MMS)
Our new clinical model will introduce new ways in which callers to 112 / 999 are triaged to ensure they receive the most appropriate care and response to suit their needs.
The changes will clearly identify those patients who require an immediate life-saving response – ‘Emergency Care’ (these patients will receive the highest priority response in the fastest time), and those ‘Urgent Care’ patients who can be managed more appropriately in a care setting other than an Emergency Department.

9. Future Model of Care

10. Future Model of Care Clinical Hub – Hear and Treat
Telephone Triage - providing advice on self care, discharge or referral to other appropriate local treatment pathway (GP and primary care, local based urgent care service, specialist services – such as mental health service, social care services, dental services)
Alternative Destinations
Aim to ensure patients are treated in the right place first time and in doing so reduce the number of patients unnecessarily taken to an ED.
- Local injuries unit or an appropriately resourced Primary Care Centre
- Specialist Centre – PCI; Stroke; Fracture; Trauma
Community Paramedic
Paramedics will function outside their customary emergency response and transport roles, in ways that facilitate more appropriate use of emergency care resources and enhance access for patients in rural and minor urban areas – take advantage of locally developing collaborations

11. Future Model of Care Dynamic Deployment See and Treat
Where Emergency Response Resources will be strategically positioned at various predetermined locations, in order to provide a more rapid response to patient needs.
See and Treat
Focused clinical assessment by paramedics at the patient’s location, followed by appropriate immediate treatment, discharge and/or referral to other services - more appropriate to needs
Community First Responders
Groups of volunteers who, within the community in which they live or work, are tasked by the NAS to respond to emergencies appropriate to their skill set
Three Community Engagement Officers appointed for each area.

12. Key Benefits of a New Model of Care
Ambulance Service
Key Benefits
Wider
Health Service
The Patient
Reduction in dispatches
Incidents dealt with more promptly
Most appropriate pathway chosen
System capacity better utilised
Reduction in ED attendances
Appropriate and immediate resolution
Care closer to home
Reduction in call cycle as no journey undertaken
More effective use of crew clinical skills
Reduction in hospital admissions
Immediate access to clinical treatment
Directed to most appropriate setting
Resolution of calls using telephone triage without the need to dispatch crews
Resolution of incident at scene without need to convey to another provider
Hear and Treat
See and Treat / Refer / Transfer
Non – Conveyance

13. 28%
2014

14. We need a Plan