Cavan ambulance service stretched - whistleblower

RECRUITMENT and retention issues in the National Ambulance Service in this region means County Cavan is regularly left with a reduced number of ambulances, and dependent on support from crews coming from Dublin.

For five nights during the week beginning November 17, for example, only one ambulance from the Virginia Ambulance Station is rostered to cover the whole county. If a second ambulance is needed in Cavan on one of those nights, it will have to travel from Finglas.

This is according to a paramedic ‘whistleblower’ who has reported “unsafe” levels of ambulance cover and “all-time low morale” amongst ambulance colleagues in Cavan.

The paramedic says the shortfall in staff is significantly adding to response times for patients.

“In three weeks’ time with the roster the way it is, there will be no ambulance cover for several nights in Cavan Ambulance Station during the week beginning November 17,” the whistleblower told the Celt.

The Celt has also learned there was reduced local ambulance cover in Cavan on two dates in October.

On Monday, October 13, there should have been four ambulances covering a 12-hour day shift from early morning, but according to a roster seen by The Anglo-Celt, crews were not rostered on three of the “lines”, which meant there was just one Cavan ambulance and the Finglas-Cavan crew to cover the whole county that day.

The situation was better the following day, Tuesday, October 14, when just one line, or shift, was left without cover.

Stations

County Cavan has two ambulance stations located in Virginia and Cavan Town. There are currently 19 full-time paramedics who cover 24 “lines” in pairs of two.

The whistlebower told us that four ambulances operate from Cavan Town Ambulance Station during the day, four days a week, and this is reduced to three on Thursdays, Saturdays and Sundays.

At night, however, there are only two ambulances working from the Cavan Town station and one from Virginia.

When required, paramedics in Finglas Ambulance Station are sent to respond to call-outs in Cavan.

In Monaghan, the situation is similar. When required, crews travel from Swords to answer Castleblayney Ambulance Station call-outs, paramedics from Drogheda are drafted in to pick up calls on behalf of the Monaghan Town Station.

The latest roster shows the NAS has left two “lines” without cover in Cavan Town Station on the night of November 17.

“When you include the Finglas-Cavan crew there should be three ambulances in Cavan, on Monday nights but if the Finglas crew get a call-out as soon as they sign on their shift at their station, they will never make it to Cavan,” the whistleblower said.

“The way things are on the roster for that week, there is only one ambulance operating from Virginia on five of the seven nights," the paramedic continued, “so, if Finglas is busy, there will be just one ambulance covering this whole county at nighttime in that peiod.”

Changes

The paramedic we spoke to said the National Ambulance Service introduced the roster changes during the summer to accommodate staff annual leave but have not reverted to the previous system.

The employee criticises the National Ambulance Service for leaving Cavan without better ambulance cover. The concerned paramedic also blames the system NAS uses to dispatch emergency calls for long ambulance response times.

The crew member detailed two incidents in the past month where a Cavan crew was dispatched to a neighbouring county.

“There was no answer at the door. The patient had made their own way to hospital because they were fed up waiting.

“The crew had to drive back to Cavan which took one hour and 10 minutes,” the employee said, “Crews are burnt out. They were on the road for two and a half hours and never saw a patient.”

Earlier this year, Cavan-Monaghan Senator Robbie Gallagher raised the issue of ambulance cover and lengthy response times in the Seanad.

He said he was approached by a paramedic in Monaghan who reported a similar experience to that of the paramedic we spoke to from Cavan.

Sen Gallagher says the National Ambulance Service has been experiencing a staff recruitment and retention problem in the north-east region and rosters have been adjusted to address the issue.

In a response to questions asked by Sen Gallagher in the Seanad, NAS said 999 /112 calls have increased by over 25% since 2019.

Emergency calls “are prioritised using an internationally recognised system that triages calls based on clinical priority, which range from life-threatening cardiac or respiratory arrest to minor illness or injury,” their statement reads.

“The NAS utilises this system to ensure the best use of resources by tasking the nearest available ambulance to the highest priority incident.”

The Celt sought a response from the HSE, but they had not replied at the time of going to print.