THE NATIONAL AMBULANCE Service has insufficient funding and staff to manage and maintain its fleet of almost 700 vehicles with some emergency ambulances being kept in service beyond the recommended age limit of five years.
A report by HSE internal auditors also revealed that funding for the replacement of ambulances operated by the NAS in 2023 is 50% below the required level.
It showed that the annual budget for ambulance replacement has remained static at €14.5 million since 2016, although the total expenditure in maintaining and replacing the fleet in 2023 was €32 million.
The audit concluded that it could only provide “limited” reassurance about the adequacy and effectiveness of the governance, risk management and internal control system for operating the NAS fleet of ambulances.
“There are weaknesses in the system of governance, risk management and controls which create a significant risk that the system will fail to meet its objectives,” it noted.
The audit added: “Action is required to improve the adequacy and/or effectiveness of the system.”
It highlighted how there were no reserve emergency ambulances at the time of the audit with no policy in place to address the issue.
In addition, no funding has been secured by the NAS to facilitate the environmental requirements for moving towards a sustainable fleet.
The audit noted that 15% of emergency ambulances – 45 out of 302 vehicles – were kept in use beyond the recommended age limit of five years with some retained in use for up to seven years.
Among the main findings, the audit highlighted how there were only five staff employed in the NAS’s fleet and assets department at the end of 2023 when it had been identified in 2021 that there would be a need for 19 posts by 2026.
One employee has responsibility for managing contracts for fuel, uniform and consumable contracts worth around €25 million, while another oversees €30-35 million capital funding.
The audit also identified a series of shortcomings and inefficiencies in the management of the NAS fleet.
It revealed that there is an incomplete listing of all NAS vehicles, while there were several maintenance contracts in place around the country which lack consistency in terms of pricing and service turnaround times.
The report showed that there was no complete listing of all breakdowns of ambulances last year.
HSE auditors said such insufficient oversight of the health of the fleet increased the risk of disruption to ambulance services.
They claimed the current practice does not facilitate oversight of expenditure for breakdowns for accurate budgeting and the tracking of frequent issues in specific vehicles and across the fleet.
However, the audit acknowledged that work was in progress on establishing a Fleet Asset Coordination Centre within the NAS which will hold real-time information on every vehicle including on repairs and servicing.
The NAS responds to over 400,000 ambulance calls each year and employs over 2,400 staff across 100 locations with a fleet of 675 vehicles.
Under Sláintecare reforms, it is proposed that the NAS will provide a monitoring service to other HSE fleet operators to support their procurement specification, regulatory and compliance requirements.
The NAS with its partners transport approximately 40,000 patients, coordinates and dispatches more than 800 air ambulance calls and completes 600 paediatric and neonatal transfers per annum.
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