At the January meeting of Dublin City Council I proposed an emergency motion seeking an additional 4 ambulances for the Dublin Fire Brigade Emergency Medical Service ( DFB EMS) to resolved their capacity issues and noted concern that the service’s call and dispatch operation might be transferred to/amalgamated with the National Ambulance Service call centre in Tallaght. That concern has now escalated to a significant potential reality, so much so that Dublin Fire Brigade’s initial intention to take industrial action 0ver their capacity issues has turned into a full scale dispute over call and dispatch.
Pertinent to understanding the dispute is understanding how DFB EMS operates. If you make a 999 call from Dublin city or county it goes to a call centre. If you need a fire brigade or an ambulance your call is transferred to the Dublin Fire Brigade call and dispatch centre in Tara St. There it is dealt with according to a highly effective protocol that maximises resources and minimises the threat to life and property. Here’s why:
Dublin Fire Brigade provides a unique fire-based EMS service that fronts 14 ambulances and supports them with local fire appliances and fire officers. It can provide this service in a most clinically effective and efficient way because all DFB officers are trained paramedics or advanced paramedics. Each officer can bring A&E expertise to the site of any medical emergency. The service operates on a zero-down-time basis meaning crews swap over to accommodate breaks to ensure the DFB ambulances are always on a call. In any one 24 hour period each ambulance could attend to a different incident every hour.
So why change this way of operating?
In 2014 HIQA published a review of Pre-hospital Emergency Care Services in Dublin. Its report highlighted several concerns and made 12 specific recommendations. One of the concerns related to emergency calls ‘dropping’ between the two services i.e. between the DFB EMS call and dispatch in Tara St. and the NAS call and dispatch in Tallaght and the potential risk to lives. DCC’s reaction to this was to consult with the HSE and each of the other 3 Dublin local authority CEOs and as a group unilaterally decided to transfer the DFB call and dispatch service to the NAS in Tallaght. Needless to say without evidence rationale or fire officer consultation there was uproar.
It was decided to form an Expert Panel to examine the HIQA report and its recommendations. It was also agreed to put together an Ambulance Forum consisting of DCC, DFB Senior Management and officer union representatives. The Expert Panel would report and this Forum and it would come to an agreement on the implementation of the recommendations in the Expert Panel’s report. This worked well and agreement was reached on the recommendations relating to the governance and financial arrangements/funding sources. However, the outstanding piece of the jigsaw is how to prevent calls dropping between the two systems.
A technical sub-group was formed with 2 telecommunication experts advising to see how the two systems could talk to each other effectively and safely. A report was drawn up with a series of different options on how to effectively proceed both in the short term and long term. This report was given to the Ambulance Forum. However, DCC pulled out of the Forum before the report could be presented and discussed rendering the Forum’s work incomplete and effectively collapsing the Forum. This raised concerns that DCC’s original plan to amalgamate the two call centres was back on the cards.
In January the Expert Panel made a presentation to the DCC Special Committee on Fire, Ambulance and Emergency Management of which I am Chair. It emphasised that moving DFB call & dispatch would not only be financially inefficient but highly dangerous from a patient safety perspective reiterating that DFB’s call and dispatch is an integral link in the cycle of pre-hospital emergency care management. While the capacity issues remains, this is now the crux of the DFB dispute with DCC. This is what DFB officers are protecting. This is why DFB will be outside City Hall for our March meeting tomorrow evening. This is why DFB voted overwhelmingly to take industrial action two weeks ago.
However, there is a safe and effective telecommunications solution to enable DFB’s call & dispatch in Tara St. to talk to the NAS centre in Tallaght. It can be implemented in a short timeframe and can fully address the concerns in the 2014 HIQA report.
Therefore, there is no rationale for amalgamating the two centres except for the yet to be understood rationale of DCC. This is why DFB EMS is calling for your support in their campaign.