As with most national St John Ambulance organisations, St John Ambulance Ireland is organised in a paramilitary fashion. Its activities are ultimately overseen by a Council, analogous to a board of trustees and chaired by the President of the Organization, currently Bill Fleming. The organisation's executive staff is led by a Commissioner appointed by the Council. In 2014 the Council appointed Mr John Hughes as the new Commissioner. Commissioner John Hughes was Acting Commissioner after the resignation of Commissioner Prof. Patrick K. Plunkett KStJ in December 2013, who assumed the role in 2008. The executive includes a Deputy Commissioner, a number of Assistant Commissioners, and the Chief Staff Officer who are responsible for different areas of the organisation's activities.