Insufficient financial and staff resources are affecting the ability of the National Ambulance Service to maintain its fleet of vehicles, Health Service Executive internal auditors have warned.
Some emergency ambulances operated by the National Ambulance Service are having to be kept on the road for up to two years longer than recommended, a new internal audit report maintains.
Internal auditors also said that there were no emergency ambulances held in reserve.
The report said the yearly budget for ambulance replacement was insufficient and that last year the amount available was 50 per cent less than needed to meet funding requirements.
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The audit report, released on Tuesday, noted 302 emergency ambulances operating countrywide by the national service.
It said official policy in the service was to replace emergency vehicles after five years. But the report found that at the end of last year, 45 emergency ambulances were still in use into the sixth year of operation.
“National Ambulance Service has adopted a replacement cycle of five years, however some emergency ambulances are currently being kept in service for up to seven years and not the outlined five years due to operational requirements.”
Auditors said that inadequate resourcing and funding of the fleet affected management’s ability to meet strategic goals.
“Increased maintenance costs to keep older emergency ambulances on the road is an inefficient use of resources.”
The report said the service responded to more than 400,000 calls each year and employed more than 2,400 staff across 100 locations.
Overall, it operates a 675-strong fleet including more than 300 emergency ambulances as well as intermediate care, rapid response and a range of specialised support vehicles.
“The yearly budget for ambulance replacement has remained at €14.5 million since 2015. This amount is based on a Hiqa [Health Information and Quality Authority] review in 2015. In 2023 the budget was €14.5 million, however, total expenditure to maintain and replace the fleet was €32 million.
“The budgeted amount allocated does not include additions, ambulance equipment [necessary for an ambulance to be fully operational] or non-ambulance vehicles.
“It does not take into consideration, an increase in the cost of an ambulance, which cost approximately €128,048 in 2016 and now costs approximately €166,050. An increase of €38,000 [30 per cent] per emergency ambulance,” noted the report.
The document also indicated five emergency ambulances were written off due to crashes last year.
“Three emergency ambulances were registered in 2022 to the regions Leinster, Dingle and Cork. Two were registered in 2019, both located in Castlebar. There are currently no reserve emergency ambulances available to provide the service lost when a vehicle is unexpectedly written off or not available for service.”
The report said the National Ambulance Service did not have a policy regarding reserve vehicles.
It also said that there were several contracts in place countrywide for the provision of vehicle maintenance services with a lack of consistency in terms of pricing and service turnaround times across regions.
The auditors also maintained that there were inconsistent practices in operation across regions in the reporting and resolution of breakdowns.
It said a complete list of breakdowns in 2023 was unavailable.
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