Last night, for the fourth night running, the Northern Ireland Ambulance Service (NIAS) was forced to deal with staff shortages that have severely impacted on paramedic cover across the north.
The situation was particularly acute over the weekend with crews from the Republic drafted in to work in Newry and Derry on Friday and Saturday nights.
On Sunday night there were no crews available to work out of the Ardoyne station, which covers north Belfast, a worrying position to be in given the violence which erupted in the New Lodge only last week.
It is reported that over the weekend the level of cover was down by around a quarter of the normal workforce, which is a significant shortfall.
As well as using voluntary and private ambulance services and calling in crews from the south, an appeal was made for NIAS staff to come in and help out.
Thankfully there were no major incidents over the weekend that would have put the service under even greater strain although the NIAS has apologised for any delays experienced during this difficult period.
Clearly, the current situation is deeply alarming and the chief executive of the service, Michael Bloomfield, is correct to say that relying on the goodwill of staff to cover shifts on an overtime basis is 'unsustainable'.
Staff are sometimes working up to 15 hour shifts, missing meals, facing long turnaround times at emergency departments and having leave cancelled.
While the past few days has received particular attention, the reality is that the ambulance service has been under pressure for some time.
In April this year, staff shortages meant that the entire city of Belfast was left without paramedic overnight cover on a Saturday night.
While additional staff are being recruited and trained, this process takes time.
It is a similar picture to that facing nurses, with not enough staff in place to cope with demand.
The problems in the ambulance service - and nursing - underline the importance of workforce planning and that includes maintaining parity in pay with the NHS in Britain.
It hardly needs to be stated just how crucial paramedics are in providing fast and skilled treatment that can make the difference between life and death.
The service needs to be fully staffed and properly resourced to ensure it can respond quickly and appropriately to any emergency.
