Dublin Fire Brigade losing ambulances to HSE

Beano wrote: »

i hope to god i dont get an awful smug b*astard like you bang bang if i ever need an ambulance.

colinjp wrote: »

Lot of DFB v NAS arguments here that are ridiculous. I work for NAS and know and have met many DFB who are great paramedics and we always get on well together at a call. I have to admit I have seen call holding by DFB dispatch first hand and this shouldn't happen. I have also had many duplicate calls where a second ambo is sent to the same call because of two seperate controls, and one didn't know the other already had a vehicle dispatched, again a waste of resources. Best thing I believe that can happen is NAS take over national ambo dispatch in the new tallaght control, DFB keep their ambos, DFB ambos get tetra radios and the nearest available ambulance gets the call no matter what organisation. There has been a lot of down talk about Nas paramedics not being as capable but every paramedic is Phecc registered and does the same training and exams so no matter whether you get a NAS or DFB ambo for your emergency , you are getting a highly trained medical professional. I can also confirm Nas staff do not get any stand down time after calls, nor are we guaranteed lunch breaks. I have personally done 12 hour shifts where I haven't gotten back to base and had to grab a sambo while getting diesel. I was talking to a DFB paramedic the other day who stated he had gone his whole shift without a proper lunch either. The fact is both organisations do a great job with the funding each management provides and will continue to do the same

Bang Bang wrote: »

I can read from this that you are a member of the DFB.
Accusing me of fabricating lies is just putting you in the same bracket as your colleague who began name calling and insulting, sad really because I had enjoyed your posts to date, initially you came across as someone who could hold a good debate, but there you go.

As for the incident involving kitchen duties, it was your colleagues who made the remark and there were more words in the conversation regarding the kitchen duties but they were just put down to the black humor that we often develop, so I may leave it there, but I hope they enjoyed their "AP chicken"!!

Getting away from the bashing and more in line with the thread title, I would like to offer some advice to a certain number of DFB personnel. If you wish to have the support of the NAS then maybe include the NAS in your campaign to save 'YOUR' ambulance service, you are not the sole Dublin ambulance service. Those members shouting this appear in a minority but also appear to be shouting very loud. Dublin City and County ambulance service is provided by and funded by the National Ambulance Service with an agreement in place for the Dublin Fire Brigade to provide 11 ambulances in support.

For those reading this thread who don't know, the National Ambulance Service have ambulance stations in Swords, James's Street, Tallaght and Loughlinstown, each operating between one and up to five ambulances per shift. There is a rostered AP RRV working out of Loughlinstown. There is a paramedic motorcycle response unit based in Cherry Orchard, there are a number of Intermediate Care Vehicles also based in Cherry Orchard who are available as back up and response to AS1 and AS2 calls, all these stations are in Dublin.
Dunshaughlin and Maynooth ambulance stations have quick access to West Dublin.

The big problem is the way the calls come through the BT exchange, some calls go to the DFB and some go to the NAS. This system has never worked and it is well over the time that something was done to sort it. There should be only one receiving command and control for all ambulances, regardless of what uniform they wear.

Remember the current report is just that, a report, recommendations are sure to come out of it, but the report will not be finalised and published until the end of May, it is then we will see the recommendations.

Worse fool you (general term) if you believe what the daily newspapers are printing before you see or hear anything official from the reporting committee.

Running to the media and calling for the report to be stopped only raises suspicions of what one may be masking or be fearful of.

Bang Bang wrote: »

Some stations are one ambulance and the larger stations have up to five ambulances for that station all on duty at the same time.

There has been a NAS existence in Dublin for many decades, including a command and control room.

NonBeliever14 wrote: »

There are some interesting comments on this thread. Some are unbelievably misinformed. Despite the obvious fact that a range of syndicating journalists have decided to accelerate HSE bashing (and by association, NAS bashing) in recent weeks, none have attempted to inject any balance or indeed challenge any so called "truths" on which much of the conjecture is based. A simple example, IFESA chairperson states 40% of all ambulance calls are in Dublin. A blatant lie, whether you use one or more categories of ambulance calls. All journalists, as well as the usual commentators (IFESA and the usual Private Ambulance operators), continue to ignore or avoid some basic facts which are extractable through an FOI request (you don't have to believe what you need here):

more than two thirds of the population live outside of Dublin (check the Census)

In December 2013, only the NAS in the MW, former East (Dublin, Kildare and Wicklow) and the Midlands achieved the 19 minute response time for DELTA/ECHO calls. This target have never been achieved in the areas of Dublin not primarily serviced by NAS

The Private Ambulance company whom is now tweeting support for DFB, sued the State in the EU Court because DFB did not compete in a procurement process. The same commentator, whom criticises NAS on an almost daily basis, sued the HSE when they tried to initially introduce the Intermediate Care Service claiming it would harm their business. PHECC are subject to FOI so it would be interesting to get copies of all correspondence they have received from the same source.

IFESA regularly call for a National Fire Service because of fragmentation and inconsistency amongst Fire Authorities. Apparently it's OK to not have a single National Ambulance Service and to have a fragmented service in Dublin

In addition to the Response KPIs published by HIQA, there is an additional "qualitative" KPI which all services collect. It relates to the percentage of ECHO/DELTA calls that are responded to by an Advanced Paramedic. DFB's own figures in 2013 put the figure at less than 5% while the NAS figure is 68%. Apparently, the quality of NAS services outside of Dublin are inferior. Is it true that Advanced Paramedics in DFB are promoted to Sub Officer and therefore stop crewing emergency ambulances?????

HIQA legislation does not provide it with powers to regulate or inspect any Fire Service. Given the public confidence in HiQA inspections, are the public happy to not have access to regulatory reassurance. The review announced by the Minister for Health, to be conducted by HIQA, will not encompass DFB, unless they volunteer themselves to it.

NAS is so dysfunctional that it is able to coordinate and deliver aeromedical services using both it's own and IRCG assets. NAS has successfully provided national access to Primary PCI therapy for MI patients whom previously were excluded because they lived on the West Coast or Border Areas.

Everyday, NAS (as does DFB) respond to patients with successful outcomes. The difference is that NAS does not have it's "customer base" captivated in a small geographical area where it has a large Fire Service workforce to use as "back up" for meal breaks, lifts, etc. because they have few fires to respond to. Rather, NAS has to deliver services to the other two thirds of the population spread out between Mizen Head to Malin Head as well as still managing to deliver a range of emergency as well as all urgent and routine services in Dublin.

NAS responds to approx. 350,000 emergency/urgent calls every year. If you search the papers, we hear about a dozen well publicised news paper headlines. For some strange reason, we don't here about the the 99.9% calls where everything went right. An example is a headline from the North East recently in a tabloid which claimed a "25 minute delay". What the journalist failed to realise or indeed accurately report was that it was a six minute delay as the first 19 minutes was the target. The second hypocrisy promoted by journalists is the omission of the fact that response time KPIs do not apply to all 999 calls, in fact it is approx 41% of 999 calls that are encompassed. In any human endeavour, including healthcare, people fail to perform or make mistakes. Whilst these mistakes can cost lives, the reality is that the World Health Alliance on Patient Safety, the peak body of same, accepts that a percentage of patients will not get the very best all of the time. That is the reality of what happens when services are delivered by human beings. The Irish response is a media witch hunt. As DFB services are delivered by humans equally doing their best, they too make mistakes.

So, why do we only hear about NAS in the media, and very little about DFB? While everything I have referred to above can be evidence based through research or FOI, I will digress on this point and offer an opinion. In my view, there is the simple reason that DFB is a small ambulance operation in a small densely populated area where most people are non affected and the media outside Dublin not interested (unless it is syndicated journalism) and the capital offers the media a greater choice of scandal. Secondly, DFB has not experienced much organisational reform to unsettle a workforce. When you couple this with a very professional ethos, built on collegiality, loyalty and pride in service, you get little "noise".

conversely, NAS faces huge geographic and demographic challenges but is benchmarked against the same metrics. Secondly, NAS staff and the public has experienced significant organisational reform and loss of income (in the case of staff). NAS does not have the loyalty, pride and collegial culture of DFB. A failure of leadership is generally the root cause. In my mind, the common denominator is the correlation between the location of the media reports, the journalists involved, the extent of loss of earnings in those areas and the degree of service reforms/parochial response. Essentially, following NAS staff running to journalists to air their grievances, these same individuals have now been "cultivated" as informants by these same journalists whom realise the ease with which HSE related stories can be extracted and probably not challenged with the actual truth. The small minority of truly disgruntled think they are getting at their management, however, what they are really doing is allowing themselves to be used to undermine the professionalism of their colleagues and erode public confidence in a national service that has so much potential given the right leadership, political support and workforce buy in.

Instead, we are due to be subjected to another prime time "expose" where in probably 20 minutes, we will be convinced lives at at risk. We will then have the subsequent IFESA, journalistic and Private Ambulance operator analysis in the usual media outlets followed by the usual outpouring of parliamentary questions from "concerned" politicians. And meanwhile, they won't have scratched the truth just further undermined the morale of a professional workforce and worried the public.

Well if we have a crisis, ask the man whom had a cardiac arrest on a golf course in Ballyshannon, was successfully resuscitated, flown to Galway, had a PCI and went home to his family what he thinks of "an ambulance service in crisis". Trouble is, he is only one of about 800,000 patients whom have a good experience of NAS every year.

The purpose of this long post is not to bash any group including DFB, but to point out that when it comes to complex services like an ambulance service, what you read, hear and watch in the media is rarely the truth.

Bang Bang wrote: »

Brilliant post 'NonBeliever14', top post of this thread without a doubt.