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The Welsh Ambulance Service has made changes to how calls to 999 are dealt with, aimed at saving more lives rather than focusing on response times.
A new purple category has been introduced for people suffering from an out-of-hospital cardiac arrest and the red category will be retained for life-threatening emergencies, including those at high risk of cardiac or respiratory arrest.
The changes are designed to ensure more people get the life-saving help they need from the ambulance service, while those who do not need an ambulance receive more appropriate care for their needs. It is hoped that they will help improve survival rates from out-of-hospital cardiac arrests in Wales, which are currently less than 5%.
The new approach has been implemented in response to a recommendation from the Senedd’s Health and Social Care Committee, which concluded the existing ambulance response target is no longer appropriate or fit for purpose. The changes place a greater focus on outcomes than response times.
“Until now, cardiac arrests have been categorised in the same way as less critical problems like breathing difficulties. This new approach ensures ambulance teams prioritise people with the most urgent needs.
“This targeted clinical response, combined with wider access to defibrillators in the community and improvements to hospital handovers, represents our commitment to improving survival rates.”
Jeremy Miles, Cabinet Secretary for Health and Social Care
The expectation is that ambulances will respond to purple and red category calls in an average of six to eight minutes, but the primary measure for purple calls will be the percentage of people to have a heartbeat restored after a cardiac arrest until arrival at hospital.
As part of the new model, rapid clinical screening will be undertaken for all calls not classified as purple or red. This will ensure every call receives a more tailored approach, which takes account of a person’s symptoms and where the incident occurred.
“Since 1974, the ambulance service has been measured by the time it takes to reach emergency calls.
“The ambulance service of today provides much more sophisticated care, so shifting the focus to how many people survive a life-or-death emergency because of our interventions, rather than how many minutes it takes us to arrive, is an important step to reflect that.”
Jason Killens, Chief Executive of the Welsh Ambulance Service
Action will also be taken to improve ambulance handover at hospitals to support ambulance capacity to respond to 999 calls in the community.
The Welsh Government’s response to the Ministerial Advisory Group on NHS Performance and Productivity included developing a plan to assess the readiness of NHS Wales to deliver a maximum 45-minute ambulance patient handover time.
NHS organisations have been set clear expectations to improve ambulance patient handover and are actively working to drive improvements. The Welsh Government has established a national, clinically-led taskforce to support this, focusing on emergency department processes and patient flow.
The Welsh Ambulance Service unveiled its new coordination and communications centre in Denbighshire in June.
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