Health
Ambulance target under review after being missed for four years
A TARGET for ambulances to respond to the most urgent 999 calls in eight minutes could be changed after services missed the mark for more than four years.
Jeremy Miles, who was appointed Wales’ health secretary in September, announced a clinician-led review of the appropriateness of emergency ambulance response targets.
The target of responding to 65% of immediately life-threatening “red” calls within eight minutes has not been met since July 2020, with latest performance standing at 50%.
In a statement on November 26, Mr Miles raised concerns about “unstainable” levels of demand, with 36,700 emergency calls in October, an average of 1,183 a day.
He told the Senedd the proportion of red category calls has soared from 4% to 5% when the target was introduced in 2015, to nearer 15% today.
Mr Miles said the ambulance service received 177 “red” calls a day in October, warning: “This was the second highest number of daily red calls to the ambulance service on record – a level of demand that is, frankly, becoming unsustainable.”
The health secretary added: “Despite the fact that the category of red calls is now approximately three times the size since the target was set in 2015, in October just over half of red calls were responded to within the target time of eight minutes.
“The ambulance service is still off target but this equates to the highest number of red calls responded to within eight minutes on record.”
He announced an expert group will review the target in the context of the Welsh Ambulance Services University NHS Trust’s evolving model of rapid clinical screening for most 999 calls.
Mr Miles said the group will consider whether new measures are required, with no response time targets currently in place for the amber nor green categories.
Sam Rowlands, the Conservatives’ shadow health secretary, suggested any change to the target could be seen as the Welsh Government trying to move the goalposts.
Mr Rowlands expressed concerns about handover delays at emergency departments, recognising a big part of the challenge remains outside the ambulance service’s control.
Mr Miles stressed the review was launched on the back of a recommendation from the Senedd’s health committee, rejecting any suggestion of seeking to swerve accountability.
“That way lies madness,” he said. “The health service is hedged around with dozens of targets. There is not a shortage of targets in the system.
“But if we are to have an honest discussion about performance in the health and care systems, we have to apply that rigour to how we look at the priorities that we set and the targets against which we measure performance.”
Plaid Cymru’s Mabon ap Gwynfor warned of grave problems in Wales’ care service, with patients unable to leave hospital to return to the community.
He told the Senedd that response time delays are a symptom of a far wider problem and the entire machinery of the health care system is in fundamental gridlock.
Mr ap Gwynfor said: “These missed targets are of course a reflection of chronic handover delays; whereas the average handover period is supposed to be 15 minutes, the current average is in excess of two hours.
“The cumulative impact was 260,000 hours being lost to handover delays at emergency departments last year.”
Mr Miles accepted that patient handover times remain “far too long” as he stressed that reducing delays is a key priority for the health service.
Labour’s Lesley Griffiths welcomed more rapid clinical screening of 999 calls after meeting Jason Killens, the chief executive of the Welsh Ambulance Services NHS Trust, last week.
The Wrexham Senedd Member said: “Having clinicians inside control rooms I think is absolutely right to target reducing harm and make sure people who are genuinely a red call receive the correct service.”
Conservative Laura Anne Jones said: “This isn’t just about statistics, it’s about lives at stake – families left waiting in fear while precious seconds tick by.
“Instead of improvement, we’re witnessing decline.”
Plaid Cymru’s Peredur Owen Griffiths welcomed the statement but argued it “stops short of the major surgery and investment that’s needed within the ambulance service”.
Health
Local nurse awarded by The Queen’s Nursing Institute
MEGAN WARE, a Learning Disability Children’s Community Nurse in Hywel Dda University Health Board, was recently awarded the ‘Dame Elizabeth Fradd Memorial Prize for Outstanding Achievement’ by the Queen’s Nursing Institute.
This prestigious award was presented to Megan in recognition of her hard work and achievements across Carmarthenshire, Ceredigion, and Pembrokeshire.
Megan was nominated by one of her lecturers in the University of South Wales. There were many reasons that helped influence her nomination for this award. She has enthusiastically embraced the opportunity to gain experience, develop and achieve. She helped with teaching year one community children’s nursing students in the Specialist Practitioner Qualification (SPQ), sharing her own learning from her clinical practice.
Her innovation and encouragement have inspired others to feel confident within their future specialist practice and she has excelled clinically, achieving all the elements of the course to a high standard.
Megan said: “I have always been passionate about making a positive difference to people’s lives and I feel so privileged to be in the position I am as a nurse working with children with learning disabilities and complex needs. I was completely shocked to have won this award but feel proud at the fact that I have been recognised for my work and efforts in completing the course.”
Megan is also the first learning disability nurse in Wales working within a community children’s nursing team to complete her SPQ in children’s community nursing. The course prepares nurses to become a specialist practitioner following the Nursing and Midwifery Council’s standards of proficiency for community nursing specialist practice qualifications. The skills taught involve health education and health promotion, how to improve quality in healthcare settings, leadership, and management and more.
Sharon Daniel, Interim Executive Director of Nursing, Quality and Patient Experience at the health board praised Megan’s achievement, saying: “I am proud of Megan for obtaining this award and for being the first learning disability nurse to study for the Specialist Practitioner Qualification in Wales. It is testament to all her hard work and commitment to extending her knowledge as a nurse working with and benefiting children in our community.”
Megan plans on finishing her dissertation and completing her Masters degree, which will help further her career.
This annual award is for the most outstanding student in the Specialist Practice Qualification in community children’s nursing across universities in Wales, England, and Northern Ireland. The Dame Elizabeth Fradd Memorial Prize was established in 2024 to honour the legacy of Dame Elizabeth Fradd, a Fellow of the Queen’s Nursing Institute and a distinguished children’s nurse.
Health
Pressures remain high despite the end of ambulance ‘critical incident’
AMBULANCE service pressures remain high despite the end of a 48-hour critical incident declared by the Welsh Ambulance Service.
The incident, triggered by overwhelming demand and a backlog of 340 emergency calls on Monday, was formally stood down after significant strain on resources.
Judith Bryce, assistant director of operations, said: “While the critical incident is behind us, significant pressures remain, and it’s really important that the public play their part to protect our precious resources for those who need them most.”
Ambulance chiefs have urged the public to use the service responsibly, advising people to only dial 999 in life-threatening emergencies and consider alternatives such as NHS 111 Wales symptom checkers, pharmacists, minor injuries units, or GPs.
“For anyone under the weather after New Year’s Eve celebrations, consider what you can do at home to self-care, including for common ailments like coughs, sore throats, and diarrhoea,” Ms Bryce added.
She also warned the public to take extra care while yellow weather warnings for heavy rain and high winds remain in place, highlighting the risk of accidents on the road and injuries from slips, trips, and falls.
The pressures extended beyond the ambulance service, with health boards including Cwm Taf Morgannwg, Hywel Dda, Aneurin Bevan, and Cardiff and Vale reporting increased demand. These boards introduced mask-wearing measures last week due to rising flu cases.
Jason Killens, chief executive of the ambulance service, described the critical situation as “very rare” and stressed the importance of using emergency services wisely.
This is not the first time a critical incident has been declared during winter pressures. In December 2020, south Wales experienced a similar crisis, while an extraordinary incident was declared in 2023 after an ambulance waited over 28 hours outside a hospital.
The Welsh government acknowledged the ongoing pressures on urgent and emergency care services and urged the public to carefully consider their options before seeking care.
Health
Critical incident declared by Welsh Ambulance Service due to demand
A “CRITICAL INCIDENT” was declared by the Welsh Ambulance Service on Monday (Dec 30) evening due to significantly increased demand and extensive handover delays.
The service, which covers more than three million people across Wales, reported over 340 calls waiting to be answered at the time the incident was declared.
More than half of the ambulance vehicles were stuck outside hospitals waiting to hand over patients, resulting in some people waiting “many hours” for an ambulance and delays in answering emergency calls.
Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, James Evans MS, said: “Another critical incident declared by the Welsh Ambulance Service with over 340 calls waiting, ambulances stuck outside hospitals, and patients waiting hours for care.
“This is not just a winter crisis, it is a symptom of long-term failures in Labour-run Wales. Patients and frontline workers deserve better.
“It’s time for real leadership to fix this problem once and for all.”
The public has been urged to call 999 only in the event of serious emergencies.
The Welsh Ambulance Services University NHS Trust said it had implemented additional measures to ensure services could continue.
Stephen Sheldon, Head of Service, said: “It is very rare that we declare a critical incident, but with significant demand on our service and more than 90 ambulances waiting to hand over patients outside of hospital, our ability to help patients has been impacted.
“Regrettably, this means that some patients will wait longer for an ambulance to arrive and for their calls to be answered.
“For that, we are very sorry because this is not the level of service we want to provide.
“We understand that this is frustrating for patients, but can assure them that we are doing everything we can to relieve the pressure on our service.”
A critical incident is the highest alert level used by the NHS, allowing management to take immediate steps to create capacity.
Sheldon added: “The public can help by only calling 999 in the event of a life-threatening emergency – that’s a cardiac arrest, chest pain, breathing difficulties, loss of consciousness, choking, or catastrophic bleeding.
“If it’s not a life-threatening emergency, then it’s important you use one of the many alternatives to 999, starting with the symptom checkers on our NHS 111 Wales website, as well as your GP, pharmacist, and minor injuries unit.”
Earlier on Monday, Walsall Healthcare NHS Trust, which operates Walsall Manor Hospital, also declared a critical incident due to rising numbers of people needing urgent and emergency hospital care, predominantly for respiratory conditions.
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