A KEY target for ambulances to respond to the most urgent 999 calls within eight minutes, which has not been met in five years, will be ditched following a review.

Jeremy Miles, Wales’ health secretary, announced a move away from the time-based target of responding to 65% of life-threatening “red” calls within eight minutes from July 1.

The Welsh Government target was last met in July 2020, with 48% of 6,073 red calls receiving an emergency response in eight minutes in January this year.

Mr Miles said a clinician-led review found the eight-minute target, which has been the standard since the 1970s, is no longer appropriate nor fit for purpose.

In a statement to the Senedd on March 11, he explained the ambulance service will trial changes over the next year which will focus on outcomes rather than response times.

A purple category – for cardiac and respiratory arrest – will be added, with the red category for major trauma, bleeding and cases where a person’s condition could rapidly deteriorate.

Mr Miles said of the current eight-minute target: “There is no evidence it helps drive better outcomes. It does not support effective clinical prioritisation.”

He added: “This means that precious ambulance resources are being dispatched to people who are less seriously ill and may not require emergency treatment or onward hospital care.

“And we measure success purely through the lens of response time in these examples. So, if an ambulance arrives in eight minutes and one second and the person survives – that would be regarded as a failure because the response time target was missed.

“But, perversely, if the ambulance arrived within eight minutes and the person unfortunately died – that would be regarded as meeting the target.”

Mr Miles said survival rates in Wales after an out-of-hospital cardiac arrest are less than 5%, compared with 9% in Scotland, 10% in England and far higher elsewhere in the world.

“This is not acceptable…,” he told the Senedd. “We must aspire to do better and to match survival rates in European countries and some US cities.”

The health secretary stated both the purple and red categories will be subject to time-based targets, with an average expected response time of six to eight minutes.

He detailed a focus on early CPR and defibrillation before announcing a group to review ambulance patient handovers, with around 27,000 hours lost due to delays in January.

Mr Miles told Senedd Members: “We must have a significant improvement in ambulance handover performance to ensure ambulances are available to respond to 999 calls in the community and not stuck outside hospitals for hours on end.”

Before the pandemic the median response time for red calls was four minutes and 30 seconds but at the beginning of this year the average was eight minutes and 17 seconds.

Most calls are “amber”, for which there is no corresponding measure, but a further review will assess whether to introduce targets for the category which includes stroke symptoms.

The Senedd’s health committee called for a review of the red target in a report published in August after taking evidence from the Welsh Ambulance Services NHS Trust.

Russell George, the Tory chair of the committee, welcomed the statement, adding: “But, of course, having targets in place is important – they’re there to ensure accountability.”

Plaid Cymru’s Mabon ap Gwynfor also backed the change in direction, describing the red response time target as “largely ornamental” over the past half a decade.

A CALL for an urgent meeting between Pembrokeshire’s leader and the local health board has been made after the board recently identified nine ‘fragile’ areas of service.

Late last year, Hywel Dda University Health Board stated a planned new west Wales hospital, based at either Whitland or St Clears, would not be up-and-running for at least a decade.

That scheme would see both Withybush Hospital, Haverfordwest and Glangwili Hospital, Carmarthen being ‘repurposed’, with community hubs developed.

In the meantime, the board heard services across the UK have consolidated and standards increased and Hywel Dda risks falling significantly behind other areas with consequences for patient care and staff recruitment, with work to support nine ‘fragile’ services in the interim of a new hospital already begun.

The board’s executive director of strategy and planning, Lee Davies said at the time: “In the absence of a new hospital in the south of our area to address challenges, we need to consider other options to bring together some of our services.

“We anticipate the emerging model, informed by work on the Clinical Services Plan, will seek to build on the strengths of each of the hospital sites in a way that builds complementary areas of expertise.”

At the March 6 meeting of Pembrokeshire County Council, a submitted question by Cllr Alistair Cameron asked: “On November 28, 2024, Hywel Dda UHB announced that, since financial support is not secured, delivery of a new hospital (to be located in either St Clears or Whitland) is likely to be at least 10 years from now.

“In the same statement the health board stated that it risks falling significantly behind other areas [of the UK] with consequences for patient care and staff recruitment and that it has identified nine fragile services: Critical Care, Emergency General Surgery, Stroke, Endoscopy, Radiology, Dermatology, Ophthalmology, Orthopaedics and Urology.

“Could the Leader of Council seek an urgent meeting between the council and the chief executive of Hywel Dda UHB so that he can explain his strategy for safeguarding these nine fragile services which are vital to Pembrokeshire residents and what action has been taken so far?”

Responding, Leader Cllr Jon Harvey said: “I share your concern about health service provision; contact has been made with the health board with regard to a meeting, a response is awaited,” adding that a seminar for councillors on the issue was also due to be held.

GPs in Wales will have a vital role in tackling NHS waiting lists and improving patient care, Health Secretary Jeremy Miles will tell the Welsh Local Medical Committees Conference on Saturday (Mar 8).

He will say the coming year must focus on transforming healthcare delivery to ensure more treatment is available closer to home. As part of this shift, GPs will take a more active role in managing waiting lists and expanding diagnostic testing in communities to ease hospital pressures.

A new initiative aimed at improving continuity of care will begin by identifying the most vulnerable patients who would benefit from seeing the same health professional at each appointment. The approach is expected to improve outcomes for people with chronic conditions and support efforts to keep more patients well at home.

With more diagnostic and treatment services moving out of hospitals and into local settings, Miles will acknowledge that funding must follow. Health boards will be required to increase and declare primary care spending to support the shift.

GP RESPONSE

While the Welsh Government is keen to shift more responsibilities to primary care, GPs have expressed concerns about workload distribution and financial support.

In January, the BMA’s Welsh GP committee accepted a revised General Medical Services (GMS) contract, which included an additional £23 million in stabilisation payments, bringing total additional investment for 2024/25 to £52.1 million. The contract ensures fair pay for practice staff, including a 6% uplift for GP partners and salaried GPs.

Dr. Gareth Oelmann, chair of the BMA’s Welsh GP committee, said: “This settlement does not resolve every issue, but it provides a solid foundation for future negotiations.”

GPs in Wales are also set to vote on a proposal requiring partners to provide a minimum number of clinical sessions, aimed at ensuring consistent patient care across practices.

Health Secretary Jeremy Miles said: “It is vital we work together to address the pressures in our NHS by improving access to care and patient flow through the system.

“The role of GPs is fundamental to bringing the system back into balance. This is not about general medical services taking on more and more but about commissioning services in a way that makes primary care sustainable.

“GPs are at the heart of their communities. I want to work with them to develop a system that values their expertise, provides them with the right tools, and ensures patients receive the care they need closer to home.”