SIPTU members in the National Ambulance Service (NAS) and Dublin Fire Brigade (DFB) are studying the recommendations contained in the HIQA “Review of pre-hospital emergency care services” which they have described as “challenging but achievable”. SIPTU Health Division Organiser, Paul Bell, said: “In its 12 recommendations the HIQA review group brings clarity to many of the areas which our members in the National Ambulance Service have identified as a cause for concern over a long period of time. The recommendations will be challenging in both how they are applied within the ambulance service. However, there is a concern that the recommendations are made without the benefit of viewing the, as yet unpublished, national capacity review of the ambulance service commissioned by the HSE.  It is also evident that the implementation of the recommendations will require a commitment from the Government for additional resources”.                    He added: “Recommendation 7 requires detailed clarification as it suggests that the key performance indicators in life threatening calls must take into account the difference in ambulance response times in a urban or rural setting”. SIPTU Sector Organiser, Brendan O’Brien said: “SIPTU members in the Dublin Fire Brigade refute any suggestion by HIQA that ambulance services can be substantially improved without greater funding being made available. There is information which shows the DFB Ambulance service has a very high efficiency rate. Also, we  welcome the fact that the report highlights the DFB’s existing clinic audit procedures. This indicates that patient outcome will now become a key performance indicator. “We also agree with the call for a proper Service Level Agreement for the ambulance service, which must include the provision of direct funding for the DFB Ambulance Service. In relation to the HIQA report highlighting the 14,000 queued emergency calls received by DFB in 2013, it should be noted that during times when demand outstrips ambulance capacity DFB fire appliances staffed by qualified paramedics are utilised in life threatening emergencies”.