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 4-5% when the target was introduced in 2015 to nearer 15% today.
‘Unsustainable’
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.
‘That way lies madness’
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.”
‘Gridlock’
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.
‘Precious seconds’
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”.