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Resilience under pressure: Ambulance staff’s adaptive response to Covid-19

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A SWANSEA UNIVERSITY study has revealed the extraordinary emotional and operational strain faced by emergency ambulance staff across the UK during the Covid-19 pandemic – and how they adapted under unprecedented pressure.

The research forms part of the TRIM project (What TRIage model is safest and most effective for the Management of 999 callers with suspected Covid-19), led by Professor Helen Snooks at Swansea. It examined how frontline responders altered triage and decision-making to cope with the surge in demand.

Dr Alison Porter, Associate Professor in Health Services Research, oversaw the strand on ambulance services and emergency departments. Her team investigated how 999 call handling and clinical practice changed during the pandemic, while also exploring the lived experiences of staff working on the frontline.

The study drew on 25 remote interviews with paramedics, call handlers and emergency clinicians from four NHS ambulance services and their partner hospitals. It identified four main themes:

  • Prioritising care with limited contact: Crews concentrated on the most urgent cases while reducing face-to-face interactions to minimise infection risk.
  • Shift to remote triage: Traditional in-person assessments gave way to remote evaluations.
  • System-wide disruption: Wider healthcare pressures disrupted patient flow and added complexity to ambulance operations.
  • Emotional and mental strain: Staff endured evolving protocols, ethical dilemmas and sustained psychological pressure.

One call handler said: “It was probably the toughest thing I’ve ever done […] I was coming home, taking my uniform off in the corridor, running into the shower, and sobbing my heart out day after day.”

Yet despite the toll, the study also found pride and resilience. An ambulance service manager noted: “We rose to the challenge during Covid and did an astounding job. Every clinician on the ground, the call takers, the dispatchers – all showed how flexible, adaptable and resilient we are as a service.”

Dr Porter said: “Emergency ambulance services operate in high-stakes environments even in normal times. During Covid-19, that pressure escalated rapidly. Our research shows the reality for frontline staff: constant change, uncertainty, and overwhelming emotional demands, while striving to deliver safe and effective care.”

The research concludes that future emergency planning should be rooted in flexibility, compassion and psychological support, to better protect frontline staff and sustain care quality in times of crisis.

Dr Mike Brady, Assistant Clinical Director for Remote Clinical Care at the Welsh Ambulance Service University NHS Trust, who contributed to the research, added: “The TRIM study reveals the intense strain on Emergency Operations Centre staff during the pandemic, as well as their remarkable adaptability in rapidly evolving circumstances. These findings remain highly relevant today, as services prepare for winter pressures, future pandemics and system-wide reforms. They highlight why ambulance services must continue to play a key role in high-quality research.”

 

Health

Plaid Cymru to hold public meeting over Withybush hospital surgery cuts

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Candidates say residents must be heard after emergency services decision

PLAID CYMRU candidates for the Ceredigion Penfro constituency will host a public meeting in Pembrokeshire to discuss concerns over the future of services at Withybush Hospital.

The event will take place at 6:30pm on Monday (Mar 31) at Letterston Village Hall, giving residents the opportunity to share their experiences and concerns following Hywel Dda University Health Board’s decision last month to remove emergency general surgery from the hospital.

Campaigners say the move will force many patients requiring urgent treatment to travel further for care, raising fears about the potential impact on patient safety in rural west Wales.

Elin Jones, Plaid Cymru lead candidate for Ceredigion Penfro, said: “Withybush is such an important hospital for the community and residents of Pembrokeshire. The decision to remove its emergency general surgery will severely weaken the life-saving capacity of this hospital.

“Plaid Cymru has long championed small rural hospitals such as Bronglais and Withybush. We need to ensure these hospitals remain strong local services within our communities. Withybush should have the basic life-saving and everyday treatment services it needs to function as a full general hospital.”

Kerry Ferguson, Plaid Cymru candidate for Pembrokeshire within the Ceredigion Penfro constituency, said the recent success of a public petition had demonstrated the strength of local feeling.

“It’s great to see that the online petition calling for Welsh Government intervention to restore emergency surgery and essential services at Withybush has reached its target, meaning it will now be debated in the Senedd,” she said.

“We are extremely disappointed by the Health Board’s decision to remove emergency general surgery at Withybush. Increased journey times for anyone in need of urgent medical treatment will put lives at risk. We need government intervention now to overturn this decision.”

Residents across Pembrokeshire have continued to raise concerns about the future of services at the hospital, which has long been a focal point in debates about healthcare provision in rural west Wales.

 

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Health

Politicians seek legal advice over hospital decisions as petition passes 11,000 signatures

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PEMBROKESHIRE’S two Members of the Senedd have written jointly to the Welsh Government’s Counsel General seeking legal advice on possible ways to challenge decisions made by Hywel Dda University Health Board affecting healthcare services in the county.

Paul Davies MS and Samuel Kurtz MS have asked the Counsel General, Julie James MS, to outline what legal mechanisms may exist to scrutinise or challenge the health board’s decision-making process, particularly in relation to changes impacting services at Withybush Hospital.

Their move comes amid growing concern from residents, clinicians and community groups about the impact of service changes on patient safety and access to care, especially in a rural county where travel times to alternative hospitals can be significant.

Public concern has also been reflected in a petition calling for intervention over the future of services at Withybush Hospital. The petition has now attracted more than 11,000 signatures and continues to gain support.

Having passed the required threshold, the petition can now be considered for debate in Senedd Cymru.

The two MSs say the level of public backing highlights the strength of feeling locally and the need for greater scrutiny of decisions being taken about healthcare provision.

Paul Davies MS said: “Residents across Pembrokeshire are deeply concerned about the cumulative impact that changes to healthcare services could have on patient safety and access to care in a rural area. The fact that more than 11,000 people have signed the petition highlights just how strongly people feel about this issue.”

Samuel Kurtz MS added: “People deserve confidence that decisions affecting vital healthcare services have been taken properly and with full consideration of the impact on local communities. We have therefore written to the Counsel General to seek advice on what legal avenues may exist to challenge these decisions and what powers the Welsh Government has to intervene where serious concerns have been raised.”

The MSs have also asked the Welsh Government to clarify what role it can play in reviewing or intervening where there are significant concerns about the governance and decision-making processes of a health board.

 

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Health

Welsh Ambulance Service to host bi-monthly Board meeting

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THE WELSH AMBULANCE SERVICE is preparing to host its bi-monthly Board meeting – and the public are invited.

Join the meeting on Thursday 26 March via Microsoft Teams to hear senior leaders cover a full agenda, including approval of the Integrated Medium-Term Plan for 2026-29, which outlines what the organisation will prioritise and deliver, how it will use its resources and how it will continue to improve care for the people of Wales over the next three years.

Board members will approve the initial revenue budget for the year ahead and receive an update on current financial performance.

The Board will also hear from Mr Clarke from Cwmbran, who describes an experience of trying to access help via 999 for his late father who was terminally ill.

There will also be an opportunity to pose a question to the Board.

Chair Colin Dennis said: “Board meetings give you the opportunity to really get to know our ambulance service, with a clear view of how important decisions are shaped and the processes behind them.

“They also create a forum to hear directly about ongoing work, explore how we can strengthen support for the Trust’s staff and patients, and connect with the people responsible for shaping those decisions.”

Click here to watch the Board meeting on Thursday 26 March 2026 from 9.30am.

This link will be active from 10 minutes before the meeting starts.

To pre-submit a question, please email [email protected] by no later than Wednesday 25 March 2026.An agenda will be available on the Trust’s website in the days prior to the meeting.

 

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