• The claim compares two statistics that sound similar but actually measure slightly different things. Context matters in interpreting the different scenarios.
  • Differences in how the Northern Ireland Ambulance Service (NIAS) and Ireland’s National Ambulance Service (NAS) categorise the seriousness of calls they receive, the targets they set themselves, and the statistics they produce to measure performance against those targets, all make simple comparisons between the two jurisdictions extremely difficult.
  • The percentages mentioned in the claim can be traced back to published performance statistics. In particular, the 18.5% NIAS figure refers to a prioritisation category which includes most (but not all) heart attack and stroke cases, but also includes other conditions.
  • Setting aside the suitability of comparisons of performance north and south of the border, there certainly are significant reasons for concern about the quality of service NIAS is currently able to provide.
  • NIAS and the Health Minister have both explicitly made these concerns clear, including with regards to Category 2 calls.

In a Written Question to the Health Minister answered on 28 March, SDLP MLA Justin McNulty asked the minister:

“For his assessment of the figures in an Irish News article on 28 January 2026 which states that less than one in five suspected heart attack and stroke patients in Northern Ireland get an ambulance in target time, compared to almost half across the border.”

The Irish News article in question stated that:

“Less than one in five suspected heart attack and stroke patients in NI get ambulance in target time, compared to almost half across border”

Is this an accurate representation of ambulance responses in Northern Ireland and the Republic of Ireland?

There are three aspects to consider:

  1. Do less than 20% of suspected heart attack and stroke patients in Northern Ireland get an ambulance within the target time?
  2. In Ireland, is this figure almost 50%?
  3. Are these two sets of statistics comparable?

There is some evidence to support the first two aspects, albeit with significant caveats.

When the Northern Ireland Ambulance Service (NIAS) is dealing with a suspected heart attack or stroke, this is usually designated as a “Category 2” priority call. However, Category 2 explicitly deals with cases when there is no immediate risk of death.

Cases involving heart attacks or strokes where there is an immediate risk to life can become higher priority (Category 1) which could result in faster response times.

Keeping that in mind, in the 12 months to March 2026 NIAS states that target response times were met in 18.5% of Category 2 calls.

Ireland’s National Ambulance Service (NAS) also has a hierarchy of response priorities depending on the circumstances of calls it receives, albeit different from the one here.

Most suspected heart attacks and strokes south of the border are likely to fall under NAS’s RED designation. According to the most recent figures FactCheckNI could find, response times to RED calls hit their targets 44% of the time.

However, as is the case north of the border, not all heart attacks or strokes will come within the same call priority classification.

Neither of these statistics perfectly capture all responses to suspected heart attacks or strokes and each designation also deals with cases other than heart attacks/strokes.

Comparing these two sets of statistics is challenging and somewhat problematic. There are significant differences in how the two ambulance services prioritise the calls they receive, the targets they have set to respond to different categories of calls, and the statistics they produce to measure themselves against these targets.

For more information, read on.

  • Source

FactCheckNI contacted Mr NcNulty about this claim. At the time of writing, we had received no reply.

We wrote to the Irish News, whose article was the basis of Justin McNulty’s written question. They clarified that they were using data sent to them by NIAS, stating that 18.5% Category 2 calls were responded to within the service’s 18-minute target between April 2025 and January 2026.

Within the article itself, NI’s Category 2 calls were compared directly to RED calls south of the border. What do these designations mean?

  • Emergency call categorisation

Both the Northern Ireland Ambulance Service (NIAS) and Ireland’s National Ambulance Service (NAS) categorise the calls they receive according to the seriousness of a person’s condition.

The NIAS response framework has four different categories of calls that require an ambulance response. This fact check will focus on the first two:

In the Republic of Ireland, NAS has six tiers in its response framework. The three highest priority tiers are:

  • PURPLE calls: life threatening – cardiac or respiratory arrest.
  • RED calls: life threatening – other than cardiac or respiratory arrest.
  • AMBER calls: serious but not life threatening – requiring urgent treatment of symptoms or prompt transport to hospital.

A Category 2 response in NI is therefore not directly equivalent to a RED call in RoI. All calls assessed as “immediately” life-threatening situations here are in Category 1, whereas when there is no immediate risk to life a call may fall into Category 2. By comparison the two two tiers south of the border both deal with different types of situations where life is at risk.

Neither PURPLE nor RED tiers explicitly refers to whether this risk is immediate, although in the case of NAS’s PURPLE calls, this is implicit given it deals with cardiac and respiratory arrests.

A RED determination is “defined as ‘patients, other than a Purple determinant, requiring an airway, breathing or circulation intervention, a level of consciousness below Alert and requires a medication administered >10% of incidents.”

AMBER covers “serious not life threatening” situations, for people who need urgent treatment to relieve symptoms or where the need for quick transport is critical – which could also include some heart attacks or strokes.

Overall these categorisations are not the same and easy comparisons between the two are very difficult given the distinct way they are shaped. In particular, the RoI system is explicitly symptoms-led, while in NI some reference is made to the suspected condition affecting patients.

This is not the only way in which services north and south of the border are different.

  • Target response times

While both ambulance services have a clear set of targets for their response times, the way these targets are constructed is different.

In Northern Ireland, the mean target response for a Category 1 emergency call is 8 minutes. The mean target for a Category 2 call is 18 minutes.

In the Republic of Ireland, both PURPLE and RED emergency calls to the National Ambulance Service have a target response time of less than 19 minutes. For PURPLE calls, the target is to respond in less than 19 minutes 75% of the time, and for RED calls, 45% of the time.  AMBER calls do not have such targets.

This means that NI has mean universal targets, while the ROI has compliance targets – i.e. what percentage of calls will be responded to within the target time.

How does each service perform against its own targets?

  • Measuring up

The latest annual figures on NIAS response times were published in July last year and cover the year 2024-25.

However, more up-to-date data is available from NIAS Trust Board papers, published on 13 February 2026, which show that in the 12 months to December 2025, the mean response time for a Category 1 call was 12 minutes 15 seconds, while the mean response time for a Category 2 call was 71 minutes and 49 seconds.

The latest NIAS Trust Board papers warn that “the delay in this category 2 response time is having a significant impact on patient safety.”

However, the percentage of responses that meet the target time are not routinely published by NIAS.

Following a Freedom of Information request to NIAS for an up-to-date figure on percentages, NIAS confirmed that the current rolling 12 month average (March 2025 – March 2026) for Category 1 calls was 36.8% while for Category 2 calls it was still 18.5%. NIAS have not published this data online so we are unable to link to it.

The most up-to-date information we could find for National Ambulance Service response times in Ireland is from 2 February 2026 when the Minister for Health, Jennifer Carroll MacNeill TD stated that 71% of PURPLE calls met the target response time, as did 44% of RED calls.

The NAS sent us figures which show that the average response time for PURPLE and RED calls from January – December 2025 was 24 minutes.

How does this all shape up with the claim itself?

  • Do less than 20% of suspected heart attack and stroke patients in Northern Ireland get an ambulance within the target time?

It is accurate to say that only 18.5% of Category 2 calls receive a response within the target time.

However, while most cases of heart attack or stroke are likely to fall within Category 2, not all of them will. 

Category 2 covers incidences of not immediately life threatening acute strokes and suspected heart attacks, as well as any other situations that fit the criteria.

Cases that involve suspected heart attack or stroke but where life is deemed to be immediately at risk do not come under Category 2 but fall instead under Category 1. There are many ways this is possible – if nothing else, both strokes and heart attacks can lead to cardiac arrest (albeit the increased risk of an arrest is not just about immediate danger and includes outcomes over a longer period).

In his response to Mr McNulty, the Health Minister notes that “senior paramedics within the Emergency Operations Centre also review Category 2 calls in real time to identify those requiring immediate intervention.” This highlights a level of dynamism in call responses that could have an effect on response times in certain cases.

FactCheckNI asked NIAS about this and they confirmed that cases of suspected heart attack or stroke can receive higher priority and, therefore, the chance of a faster response time (note again that Category 1 calls hit their target in 36.8% of cases).

On the other hand, it is made clear in the Irish News article that they are referring specifically to Category 2 calls and the 18.5% success rate against the NIAS target time:

“Just 18.5% of Northern Ireland Ambulance Service (NIAS) Category 2 calls were responded to within the service’s 18-minute target between April 2025 and January 2026 … Meanwhile, 45% of equivalent RED calls in the Republic were responded to within 19 minutes during 2025, meeting the National Ambulance Service’s target for such cases.”

Overall, it is not totally unfair to present this statistic as it is in the original claim, but it is a simplification.

  • In Ireland, is this figure almost 50%?

It is accurate to say that RED responses in Ireland hit their targets almost half the time (44% according to the latest figures we could find). However, this does not account for all cases of heart attack or stroke. In correspondence with FactCheckNI, NIAS said:

“The National Ambulance Service (NAS) does not triage calls based on a confirmed diagnosis, such as a “heart attack” or “stroke”, but on the symptoms described by the caller …

“This system prioritises calls by clinical urgency, based on reported symptoms such as chest pain, breathing difficulty, facial droop and so on …

“Where symptoms suggest an immediately life-threatening illness, calls are prioritised as PURPLE or RED for urgent response. In some cases, where symptoms of a potential heart attack or stroke are less clear or evolving, a call may initially receive an AMBER response, with all calls continuously monitored and upgraded if the situation changes.”

The Irish News piece does also lay out that it is specifically referring to RED calls in Ireland. While this will not capture all responses to suspected incidents of heart attack or stroke, it still may have some use as a proxy measure as it is the category that most closely aligns with these conditions.

Based on that, it is again not unfair to present the second statistic as it is in the newspaper article or question to the minister, but more context could have been provided.

  • Are these two sets of statistics comparable?

If the aim is to compare ambulance response times in cases of suspected heart attack or stroke on both sides of the border, this comparison might be the best one that is available – or at least most straightforward – but that doesn’t mean it is totally sound.

It is crucial to bear in mind the serious limitations involved in setting these two statistics side by side. It is not a robust comparison.

This was also pointed out by Health Minister Mike Nesbitt in response to Mr McNulty’s Written Question. Mr Nesbitt said:

“While I acknowledge the concerns raised by the figures in the Irish News article of 28 January 2026, direct comparison between the Northern Ireland Ambulance Service (NIAS) and the National Ambulance Service is not straightforward. Both services operate within fundamentally different healthcare systems, with distinct emergency department (ED) structures, patient pathways and access arrangements. These systemic differences have a significant bearing on measured response times and limit the validity of a likeforlike [sic] comparison.”

These comments are borne out by our analysis, laid out above.

  • Wider conclusions

The Irish News article states that “Category 2 and RED calls cover the same emergencies: possible heart attacks, strokes, serious breathing problems and major trauma.” As outlined above, this is not entirely accurate and the situation is more complex.

The same news article contains quotes from NIAS outlining that ambulance handover times at hospitals are a major concern, and that:

“NIAS continues to prioritise the sickest patients and those with the most urgent clinical need, ensuring that life-threatening emergencies receive the fastest possible response available.

“Our delayed response to Category 2 calls continues to cause NIAS concern, particularly in response to patient safety, and we recognise the impact these delays have on patients and families and sincerely apologise to anyone experiencing lengthy waits. It is not the service we want to provide, but we are working closely with partners to stabilise the system and protect patient safety.”

There is also the quotation from the NIAS Trust board paper which says that “the delay in this category 2 response time is having a significant impact on patient safety.”

The issues in this fact check boil down to the validity of comparisons. The differences north and south of the border between how different emergency calls are categorised, how targets for response times are set, and how data is collected and presented against those targets all make direct comparisons extremely challenging.

However, none of this should detract from the fact there are legitimate concerns about the current response times from NIAS.

Based solely on its own figures, there is clear cause for significant worry about the quality of service the organisation is able to provide in current circumstances and possible impacts on patient safety – particularly with regard to Category 2 calls, as indeed has been highlighted by NIAS itself.