Written question WQ85821

Given the significant challenges the Welsh ambulance service has been experiencing and the impact on emergency ambulance response times, I recently tasked the Emergency Ambulance Services Committee (EASC) to develop a refreshed and enhanced ambulance improvement plan.

The plan was approved by Health Board Chief Executives last month and includes a range of actions for the Welsh Ambulance Services Trust (WAST), Health Boards, and actions for joint delivery, including:

• Ambulance workforce efficiencies to unlock ambulance capacity - through implementation of new rosters in September-November to align capacity to demand with an equivalent efficiency of 74 WTE; a 40-point plan to reduce sickness absence and engagement with unions on delivering prudent workforce practices;

• An additional 100 frontline ambulance staff expect to be operational by the end of December, following Welsh Government investment of £3m to increase ambulance capacity;

• Joint improvement actions to support better management of 999 patients in the community or through alternative pathways to Emergency Departments and improve ambulance patient handover;

• Health Board actions to improve patient flow through hospital systems.

Urgent action has also been driven by Welsh Government over the past six – eight weeks to direct Health Boards to take ownership of the challenges to the urgent and emergency care system.

An extraordinary ‘urgent and emergency care summit meeting’ was convened with NHS Wales Chairs and Chief Executives by Judith Paget, Director General of Health and Social Services and the NHS Wales Chief Executive, A number of urgent agreed actions were identified for delivery to support improvement. including an ‘immediate release protocol’ and ‘Fit to sit’ operational policy to help release ambulance crews. These actions have been integrated into the EASC ambulance improvement plan.

At my most recent meeting with NHS Wales Chairs and Chief Executives, there was a focussed discussion on urgent and emergency care pressures and specifically ambulance patient handover delays and ambulance performance. I reiterated my expectations that health boards must work together, and with the Welsh ambulance service and partners to understand local, regional and national challenges and agree collaborative actions to ensure patients within their communities receive safe and timely access to assessment and treatment and ensuring ambulance crews are available to respond when needed, through a whole system approach.

On 8 July, I issued a written statement outlining progress against delivery of the Six Goals for Urgent and Emergency Care Programme, which has been established to secure improvements across the pathway. This includes a specific focus on strengthening clinically safe alternatives to admission and rapid emergency care response and improving patient flow through the hospital system and out into the community.

My officials have also directed health boards to produce handover performance improvement trajectories with an initial focus on eradicating delays over 4 hours and reducing the average ambulance patient handover time on a monthly basis. Health boards will be held to account for delivery against these plans through regular Integrated Quality, Planning and Delivery (IQPD) meetings held with each health board.