Written question WQ87766

The Welsh Government and Health Education and Improvement Wales (HEIW) have a leading role in setting the policy for the education, training and development of NHS workforce in Wales. I expect all NHS Wales organisations to ensure staff are trained in line with current clinical notices and guidelines.

The Welsh Ambulance Services NHS Trust (WAST) is committed to ensuring all its staff and volunteers have access to the best training and personal development opportunities, and that all training meets the professional and regulatory requirements for their role.

The WAST community first responder training team provides comprehensive guidance on ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) during community first responder training courses. This includes:

• A laminate is provided to demonstrate what a DNACPR looks like;

• Day two of the training course covers “When NOT to Resuscitate”; and

• A DNACPR FAQ document is available on the community first responder training portal for review at any time.

Should a community first responder have concerns regarding the validity of a DNACPR, they are referred to guidance issued by the Association of Ambulance Chief Executives (AACE) in 2016, which states that: “Ultimately, if you are unsure about the validity of previously made decisions, then commencing resuscitation is defendable”. Should a community first responder still be unclear about action to be undertaken while questioning the validity of a DNACPR, they are advised to contact the WAST 999 contact centre dispatch desk and seek further advice.

In July 2022, all community first responder volunteers were provided with a document which informs them of the appropriate team to contact for different scenarios, providing examples of appropriate reasons to call. A dedicated community first responder line into the clinical support desk was introduced in July 2022 to support community first responders with immediately life-threatening conditions.

The WAST Resource Escalation Action Plan is an operational planning document, which includes four levels of escalation, with quantifiable trigger factors and consistent actions at each of these levels to protect the core services. The intent is to supply the best possible level of service, prioritising the most clinically vulnerable patients, with the resources available at times of increased pressure.