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 – 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.
