In the past decade the Northern Ireland Ambulance Service improved its performance figures against a background of tightened budgets, soaring demand and problems at hospital emergency departments.
Response targets are more ambitious than in the Republic. The most serious emergencies, where lives are at imminent risk, known as category A calls, should be responded to within eight minutes in at least 72.5 per cent of cases.
This is similar to the Health Information and Quality Authority (Hiqa) demand that first responders – trained to attend emergency calls and provide care until an ambulance arrives – attend emergencies within eight minutes, but without the longer 19-minute limit for the arrival of an ambulance.
In all but one region of the North, however, these targets are being missed. Rural parts of south Down, Armagh and Tyrone are among the areas in which response times are longest.
Only the greater Belfast area bettered the 72.5 per cent target. Emergencies in the city are attended within eight minutes in more than 87 per cent of cases. However, the other four areas failed in this regard, with three falling below even the minimum target of 65 per cent.
In the whole of the North, 68.5 per cent of vehicles met the response time, but the trend in recent years has been towards quicker responses.
According to the Stormont department of health, almost £100 million (€122 million) is being invested in the Northern Ireland Ambulance Service (NIAS) in the decade to 2018. Most will be spent on equipment and on improving the ambulance and rapid-response vehicle (RRV) fleets.
Minister for health Edwin Poots points to the greatest problem faced by those attempting to meet the 72.5 per cent target for the sub-eight minute response time. “Given the lower level of category A demand in rural areas, it would not be operationally or financially feasible to deploy an emergency resource in areas where demand indicates it will sit unused for significant periods.” he said.
“NIAS deploys ambulances tactically to ensure that available ambulance resources are deployed where calls are most likely to originate, and where existing ambulance resources can have the greatest impact for the greatest number of patients.
“This means that the response to an emergency call may be provided by an ambulance or RRV which is not actually based at the nearest ambulance station.”
Nuisance and hoax calls, along with attacks on ambulance staff, are also hampering better response times. According to the minister, one in five 999 calls for an ambulance last year were non-emergencies.
The ambulance service got 1,686 hoax calls, 2,476 people called for information only, and 735 people called for help to get them back into bed.