Written question WQ91457

The Cymru High Acuity Response Units (CHARU) were established by the Welsh Ambulance Services NHS Trust (WAST), with the support of commissioners, to provide responses to people with high acuity needs.

CHARU paramedics provide advanced clinical decision making, co-ordinate patient care and ensure clinical practice is in line with current best practice guidelines to improve overall outcomes.

The CHARUs are a key facet of the Welsh Ambulance Service’s clinical response model focused on improving clinical outcomes and experience; thus moving away from the traditional perception of an ambulance service solely focused on timeliness of response and conveyance of patients to the emergency department.

The CHARU service has been instrumental, as part of a wider strategy, for improving clinical outcomes for people who have suffered a cardiac arrest in the community.

We are monitoring the impact of CHARUs and other elements of service delivery through regular integrated quality planning and delivery meetings with the Emergency Ambulance Services Committee and WAST.

Turning to ambulance response performance in the Cwm Taf Morgannwg University Health Board area, I was disappointed to see the latest figures released for January 2024. WAST’s ability to respond quickly is unfortunately compromised by ambulance handover delays which limits ambulance availability to respond to 999 calls in local communities. However, there are actions within the gift of WAST to support improvement and I have communicated my disappointment about performance to the chair and chief executive.

WAST has improvement plans in place, and as part of these plans is working with commissioners to regularly review current and future demand, and the amount and type of capacity required to respond to this forecast demand. The Trust is currently undertaking its second strategic ‘emergency medical services’ demand and capacity review.

I have also been explicit with health boards of my expectation for improvement in ambulance patient handover performance to release vehicles and improve responsiveness.

The Cwm Taf Morgannwg UHB has an Integrated Commissioning Action Plan, developed between the health board and WAST, to deliver improvements. I have set out some of actions within the plan below:

· The health board has established a 24/7 Navigation Hub – funded by Welsh Government programme monies - to support emergency and urgent demand through triage and advice lines for professionals working in the community.

· Additional areas have been identified to create extra ‘fit to sit’ capacity within emergency departments and acute medical units to help maintain patient flow and enable timelier handover of patients from conveying vehicles.

· Additional same day emergency care capacity – also funded by Welsh Government programme – has been stepped-up across all sites and the health board is seeking to use its navigation hub to increase direct referrals into this service and reduce demand on emergency departments.

· Virtual wards and Population Health Management (PHM) – using PHM data, the health board has risk stratified the highest risk cohorts within each GP practice and ensured that clear management plans are in place to help manage these patients in the community and reduce the requirement for conveyance to hospital.