Report finds HSE doesn't know size and roadworthiness of its ambulance fleet
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The HSE has no clear picture regarding the size and general roadworthiness of its ambulance fleet, a new audit report has found.
An internal audit investigation of the National Ambulance Service’s (NAS) procurement and records processes found that the organisation’s listings for its fleet were “incomplete” and “not reflective” of the HSE’s own figures tallying its assets.
The report found that there was no nationwide register for breakdowns suffered by emergency vehicles, and that the information available “was inaccurate and had inconsistency across the regional areas”.
That fact stemmed from a scenario which sees several contracts in place across regions nationwide for the provision of vehicle maintenance services for the fleet, with a “lack of consistency” in terms of the pricing applied and expected service turnaround times of emergency vehicles.
It noted that the lack of information regarding how roadworthy the fleet is equates to “insufficient oversight of the fleet” and that it “increases the risk of service disruption”.
The report said that only ‘limited assurance’ could be given regarding the adequacy and effectiveness of the governance and controls in place for managing the ambulance fleet.
The NAS currently responds to more than 400,000 calls each year and transports roughly 40,000 patients. Patient figures relying on the service are projected to more than double on their 2017 levels by 2027.
There are currently 675 emergency vehicles — including emergency ambulances, critical care units, and incident support vehicles — in use across the service.
Of the 302 ambulances active, 45 are greater than five years old — the target maximum age for a vehicle in use by the HSE, a fact which led the report to conclude that “increased maintenance costs to keep older (ambulances) on the road is an inefficient use of resources”.
Separately, the budget for ambulance fleet renewal has not changed from the €14.5m allocated in 2016, despite the fact that €32m was required to maintain and replace the fleet in 2023.
Meanwhile, there are no reserve emergency ambulances available to the NAS should one of the 302 in active service be unexpectedly written off — as was the case on five occasions in 2023.
Such a “lack of resources to support contingency planning impacts ability to provide adequate service delivery”, the report said.
The auditors meanwhile found that there are currently just five staff working across the fleet and assets department in the NAS, despite a workforce of 19 posts having been sanctioned out to 2026.
While those postings are acknowledged as an identified need and a “significant number” had been approved for recruitment in 2022 and 2023, the jobs were eventually “de-limited” as a result of the HSE’s recruitment embargo implemented in late 2023.
That meant that responsibility for contract management and capital expenditure, worth roughly €60m per year, within the NAS is currently being handled by two relatively junior employees.
One of those workers has sole responsibility for managing fuel and uniform contracts worth approximately €25m, while the second worker is responsible for the vehicle register part of the capital funding budget.
That situation has seen the relevant responsibilities effectively siloed and without “proper authorisation” for the work being done.
The report concluded by recommending that NAS management should conduct a “comprehensive” review of the internal audit’s findings and come up with an action plan “to address the deficiencies identified”, including relevant “detailed” costings.