‘Abusing the Ambulance Service’: Fears over rising ambulance referrals from NoWDOC

Concerns have been expressed at the volume of ambulances being dispatched for people who contact the NoWDOC out of hours service.

In the last three years, a total of 182,663 people contacted the NoWDOC service with 10,623 of those calls subsequently connected to the ambulance service.

The number represents 5.8% of the calls and Councillor Ciaran Brogan told a Regional Health Forum West meeting that there are concerns at the trend.

“Is there more that we can do for more engagement with GPs and the out-of-hours service,” he said. “I am concerned that far too often now when people are in contact, maybe an ambulance is sent for without a doctor going out.”

Councillor Brogan suggested it was time to review this.

“The general feeling would be that it is abusing the ambulance service and sometimes those who need the ambulance the most don’t get the ambulance,” he said, noting an apparent decrease in the volume of dispatches of a doctor on call from NoWDOC out to homes.

In 2023, 66,322 people contacted the out-of-hours service. Of those, 3,558 were connected to the ambulance service after a discussion with the nurse and a further 144 following a talk to a doctor.

In 2024, out of a total of 64,442 calls, 3,700 were connected to an ambulance after talking with a nurse and 138 after speaking with a doctor.

So far in 2025, there have been 51,899 calls to NoWDOC with 113 of those connected to an ambulance after speaking to a doctor and another 2,970 refereed to the ambulance service after advice from a nurse.

Dermot Monaghan, the HSE’s Integrated Healthcare Area Manager for Donegal, said the figures “do prompt a conversation” and said there needs to be “an honest conversation”.

JJ McGowan, the Chief Ambulance Officer in the HSE West, said there have been negotiations on the matter.

“The NoWDOC service has to be risk averse,” he said. “It can’t take any chances whatsoever as it is a telephone triage. If a patient mentions anything like chest pain or a shortness of breath, an ambulance has to be dispatched.”

Read next: Concerns over mental health care as ‘outgrown’ psychiatric unit left off new LUH plan

He said that there are attempts to “bolster up” the guidelines, but they would still have to remain risk averse.

Councillor Brogan added: “Anything should be done to keep people out of the hospital system”.