The Role of the NORTHERN IRELAND Ambulance Service

The Role of the Ambulance ServiceThe Northern Ireland Ambulance Service Health & Social Care Trust (NIAS) is the statutory agency tasked with the delivery of an emergency ambulance response across Northern Ireland. This is delivered through a combination of the Accident and Emergency tier which is responsible for emergency and unscheduled response work and the Patient Care Service which undertakes routine and elective transport of patients

Communication and organisation of emergency ambulance responses is handled by the regional Emergency Ambulance Control (EAC) based in Belfast which receives all ambulance 999 calls as well as urgent requests from other healthcare professionals and facilities, while elective transport requests are handled by the Non- Emergency Ambulance Control (NEAC) based in Altnagelvin.

Emergency response work is presently undertaken by HPC-registered paramedics and/or Emergency Medical Technicians who may at times be the first point of contact with the health service for patients with mental health needs, and their roles include:

• Assessment of patients to determine their medical and/or social need including a judgement on the patient's capacity to consent to treatment and an assessment of the risk of harm to the patient or other parties.
• Treatment of patients, including safeguarding of vulnerable patients and those who are deemed to lack the capacity to give or withhold consent.
• Liaison with other appropriate healthcare professionals.
• Transport of patients to appropriate healthcare facility, including the transport of patients subject to formal admission under the Mental Health (Northern Ireland) Order 1986.

Where patients have already been assessed by other healthcare colleagues and an appropriate course of action determined, ambulance staff will observe their professional primacy, and the role of the ambulance service is primarily supportive in the provision of transport either to or between healthcare facilities. However, during this journey an ambulance crew has a professional responsibility to a patient, and must always act in their best interests. This will include a risk assessment of the proposed method of transporting the patient and in cases where it is believed that there may be a significant risk of flight or harm, the ambulance service may be accompanied by the approved social worker or mental health staff, or in case of a substantial risk of harm or violence they may also request the assistance of the police to mitigate the risk. In acting in best interest of a patient who lacks capacity or is subject to formal admission, they may also apply the legal use of appropriate restraint in order to safeguard a patient.

While Patient Care Service Staff are primarily involved in the elective transport of patients they are trained to render emergency first aid care to any patient and can request backup from colleagues in the emergency tier if required.