Jeremy Miles MS, Cabinet Secretary for Health and Social Care
A new ambulance performance framework is being launched today, which responds to recommendations made in the Senedd Health and Social Care Committee’s review of the red 999 eight-minute ambulance response target.
It will prioritise people with the most critical needs and help to accelerate improvements in survival rates from out-of-hospital cardiac arrests.
As I have previously outlined to Members, two new categories for the most serious and life-threatening 999 calls will be created: a purple arrest category – for people suffering a suspected cardiac and respiratory arrest – and a red emergency category – for people at high risk of cardiac and respiratory arrest, including where this is a result of injury or illness.
The expectation is that these calls will receive a response in an average of six to eight minutes. But the primary performance measure for purple 999 calls will be the percentage of people who have a heartbeat restored after a cardiac arrest which is subsequently retained until arrival at hospital.
To ensure every person calling 999 receives a more tailored approach, which takes account their symptoms and where the incident occurred, rapid clinical screening will be undertaken for everyone who is not classified as a purple or red call. Every person will receive a tailored response but not everyone will need an ambulance; they may receive a different clinical response, which is appropriate to their needs.
Members will recall I have also commissioned a phase two review of the amber emergency ambulance response standards. I will provide a further update about the results of this work shortly.
To support the changes and to help save more lives from out-of-hospital cardiac arrest, I have made an additional £500,000 available to the Welsh Ambulance Service for 500 more Automated External Defibrillators (AEDs) to be placed in strategically-targeted community locations. From tomorrow, Save a Life Cymru will transfer into the Welsh Ambulance Service.
If we are to realise the full benefits of these changes, the NHS must urgently prioritise improvements in ambulance patient handover at hospital emergency departments. Too many people experience too many delays at present, which result in avoidable harm, including to individual patients; there is an impact on NHS staff morale and a knock-on effect on ambulance availability to respond to further 999 calls in the community.
The independent Getting it Right First Time (GIRFT) and Ministerial Advisory Group on NHS Performance and Productivity report have both underscored the need for change. I am therefore today announcing a National Handover-45 Taskforce to support health boards and the Welsh Ambulance Service to deliver system-wide improvements to improve ambulance handover.
The taskforce will:
- Develop and support delivery of high-impact clinical pathways in the community
- Support delivery of effective evidence-based emergency department processes
- Support delivery of evidence-based processes to improve the flow of patients from emergency departments to wards and optimise discharge.
It will play a key role in assessing and supporting the readiness of NHS Wales to deliver every ambulance patient handover within 15 minutes as far as practically possible, but always within 45 minutes.
The taskforce will be led by:
- Jennifer Winslade – Executive director of nursing at Aneurin Bevan University Health Board.
- James Severs – Executive director of allied health professions and health science at Hywel Dda University Health Board.
- Dr David Fluck – Executive director of precision medicine and executive medical director at Cardiff and Vale University Health Board.
- Andy Swinburn – Executive director of paramedicine, Welsh Ambulance Services University NHS Trust.
- Liam Williams – Executive director of quality and nursing, Welsh Ambulance Services University NHS Trust.
They will be supported by NHS Wales Performance and Improvement and the NHS Wales Joint Commissioning Committee.
There has been some encouraging signs of improvement in recent weeks as a result of local strategies. These approaches will be shared with all health boards and the taskforce will also draw on other successful cultures, processes and models from across the UK.
The taskforce will also be responsible for delivering a community-based falls response and a breathlessness pathways – the two most common reasons for 999 calls in Wales. I expect health boards and the ambulance service to improve the management of people who have fallen by providing more care closer to home and reducing the number of people who are taken to emergency departments and subsequently admitted who either have no injury or a minor injury by 10% by the end of December and by 25% by end of March 2026.
I have allocated an additional £18.8m to health boards for delivery of their Six Goals for Urgent and Emergency Care programme plans, which will contribute towards the objectives of the taskforce.
I expect all NHS organisations to prioritise working with the taskforce to improve emergency and urgent care and outcomes for people.