Written question WQ83873

We expect all patients to be transferred from the care of ambulance staff to emergency department clinicians in order of clinical priority and always in a timely manner.

Ensuring sufficient capacity to facilitate timely handover for patients and crews is the operational responsibility of Aneurin Bevan University Health Board.

In response to your specific question about the number of hospital handover delays reported at the Grange University Hospital since it opened, there have been 8,489 ambulance patient handover delays in excess of an hour at the site since November 2020.

A range of local and system-wide factors contribute to these delays, including the physical capacity within emergency departments, increased levels of demand and pressures elsewhere in the system.

The Emergency Ambulance Services Committee Delivery Plan sets out a range of time-bound actions, to be delivered between now and the end of March 2022.

Key actions outlined in the plan to manage 999 demand in the community include:

• Increasing numbers of paramedics in clinical contact centres to help discharge appropriate patients over the telephone;

• Optimising implementation and use of specialist advice and guidance for ambulance clinicians, including Consultant Connect, across all health boards;

• Health board clinicians directly managing ambulance patients and redirecting them to clinically safe alternatives; and

• Promoting the consistent use of physician triage and assessment across all health boards to support robust remote clinical assessment of patients who have requested an ambulance to hospital.

The Welsh Ambulance Service will working closely with health boards to identify existing areas or procure temporary units to create additional space where ambulance staff can safely care for multiple patients. This will enable patients to be offloaded from ambulances before being transferred into the main emergency department and allow ambulance vehicles to be released to respond to calls in the community.

This temporary practice of ‘safe patient cohorting’ is expected to begin at the Grange University Hospital within weeks, with other sites expected to follow over the coming months.

Funding has also been allocated to Aneurin Bevan University Health Board to support transformation of urgent and emergency care services, focusing on key actions which should support improved patient flow through the system to enable more timely ambulance patient handovers. Funding allocated to the health board includes:

• Additional capital funding allocated for a same day emergency care (SDEC) unit with revenue funding made available to the health board to test this new approach whilst the model develops. This will support people who need a face-to-face assessment, diagnostics and/or treatment to return home on the same day where it is clinically safe to do so.

• Funding for development of urgent primary care centre and remote clinical streaming hub to help manage more demand in the community.

• Funding for the Gwent Regional Partnership Board to support consistent delivery of ‘discharge to recover then assess’ pathways as part of a ‘home first approach’ to optimise outcomes and experience for people who have been admitted to hospital and need some additional support on their return to their local communities.