Who are Wales Air Ambulance? Expand The Wales Air Ambulance service is delivered via a unique Third sector and Public Sector partnership. The Charity raises the funds for the helicopter and rapid response vehicle operations (£11.2 million every year). The Emergency Medical Retrieval and Transfer Service (EMRTS) supplies highly skilled NHS consultants and critical care practitioners who work on board the Charity’s vehicles. Our lifesaving service is delivered by air and by road. We have four helicopters and a fleet of rapid response vehicles. These are currently based in Caernarfon, Welshpool, Dafen (Llanelli) and Cardiff. In 2024, we expect to reach a huge milestone, 50,000 missions. Our crews attend around 4,000 incidents each year across Wales, helping patients, wherever and whenever they need us.
What will the service improvement look like? Expand In April 2024, the Joint Commissioning Committee agreed that the following changes should be made. The current resources in Caernarfon and Welshpool should come together in one base location in the middle of North Wales, near the A55. Two teams will operate from the new base. To meet the pattern of demand, one team will operate between 8am and 8pm and another team will operate between 2pm and 2am. This means two crews and two aircraft – the same resources currently deployed in Mid and North Wales – will operate but they will be able to save more lives through a change in the way they operate.
What does the Wales Air Ambulance do? Expand Our service is consultant-led, which means we take hospital-standard treatments to the patient and, if required, transfer them directly to the most appropriate hospital for their illness or injury. This can be within Wales or to specialist treatment centres in England. For the patient, this can mean hours saved when compared to standard care and is proven to greatly improve survival and recovery. Our service attends the highest-level emergency calls that involve life or limb-threatening incidents. We attend less than 1% of all 999 calls received via the Welsh Ambulance Service Contact Centre. We are a pan-Wales service. With only four teams covering the whole of our country, we are a scarce and highly specialised resource. Therefore, regardless of where they are based, our dedicated crews will travel the length and breadth of the country to deliver emergency lifesaving care. Our service does not replace the Welsh Ambulance Service, we work in partnership with them. In most cases, a road ambulance will be on the scene of an incident before us. In the chain of emergency care, Welsh Ambulance Service medics offer the initial immediate care. Wales Air Ambulance is the next link in the chain, delivering advanced hospital-standard treatments even before patients get to a hospital.
What does the Joint Commissioning Committee decision mean for the Charity? Expand We can now move forward with the service improvement development which includes the creation of a new base. We believe this will be achievable within the next few years. This is the start of a journey to reduce unmet need across Wales. There is more than we can do, and we will work with all partners and stakeholders to ensure that we can save as many lives as possible. We will start work immediately on the planning for a new facility. We will do this with the involvement of our service’s medical and aviation colleagues to create a site that meets their needs. We will also be engaging with the NHS Wales Joint Commissioning Committee which will set out the implementation plan in more detail. This will include key milestones and timescales.
Why has the charity not spoken publicly about the review until now? Expand The EMRTS Service Review was independently led by the Chief Ambulance Services Commissioner for Wales. We have respected the independence of the process, having no direct involvement in the Review (this focused on our NHS partners, EMRTS) and avoiding commentary on it. This has been difficult for us. Some communities in northern parts of Mid Wales and North West Wales have shared their anxieties about a potential change during the Review’s three periods of public engagement. We strongly empathise with the genuine concerns and anxieties that have been expressed about wider NHS Primary and Secondary care provision in these regions. As a very small and very specialist service, we are a small cog in the wider machinery of pre-hospital emergency care. There is very little we can do to address many of those concerns and nor should we be responsible for covering gaps in NHS provision. We have raised this with the Chief Ambulance Services Commissioner, and he has reassured us that these issues have been passed on to the appropriate NHS representatives for their information and action. Now that the NHS’s Joint Commissioning Committee have made a decision, we are able to answer your questions and concerns. During the 18-month review period, there has been a lot of misinformation circulating about the future of our service – we hope to reassure you of our intentions and priorities. We want to be open and transparent as we move forward and will include you in our journey every step of the way as we work towards improving our lifesaving service in the years to come.
Where can I read the Review and study the evidence? Expand You can read the Chief Ambulance Services Commissioner’s full report via https://easc.nhs.wales/engagement/sdp/
Is this a cost-cutting exercise? Expand No. From the outset we were clear, the purpose of the Review was to get the best out of existing assets and resources. This is purely focused on improving our service for everybody in Wales.
Will you be reducing the number of helicopters? Expand No. We will continue to deliver our service with four aircraft and a fleet of rapid response vehicles.
Is Wales Air Ambulance a regional service? Expand No. Wales Air Ambulance is a pan-Wales service. We are a scarce, highly specialist service. Regardless of where they are based, our crews will travel to any part of Wales to deliver their lifesaving treatments. We aim to provide an equitable service across Wales. The entire population has access to air-based assets, road-based coverage is more limited due to road network limitations, topography, and base locations. The Joint Commissioning Committee has also approved the development of a commissioning proposal for bespoke road-based enhanced and/or critical care services in rural and remote areas.
How does this affect your response times? Expand Wales Air Ambulance is not designed to meet ambulance response times. When it comes to our specialist service, it is important to remember the following points: We are a pan-Wales service Any comment about increased response times because of a base move assumes that we are coming from one particular base. In reality, an incident could be attended by any one of our Wales Air Ambulance crews, regardless of where they are in Wales. Our service is not about where we come from, it is about where we go, the vital treatments that we deliver at the scene, and taking patients directly to the healthcare facility that caters for their specialist needs. We are not designed to be the first on scene Our Welsh Ambulance Service colleagues are usually on scene before us and will offer the initial emergency treatments. Our involvement is secondary when we arrive and deliver the advanced hospital standard treatments. So, while the speed of response is important when considering life and limb-threatening illness or injury, Wales Air Ambulance is not there to provide a primary response to these incidents, that role remains with the Welsh Ambulance Service. We already save a significant amount of time for a patient to receive specialist care It is also important to remember that by delivering hospital-standard treatments at the scene and taking the patient directly to specialist care, we already save a significant amount of time – hours in some cases – for the patient to receive the right treatment. Of course, our service needs to be timely but shaving minutes and seconds off response times is not clinically necessary. We have proved that our attendance significantly improves a patient’s chances of survival and long-term recovery – and it is important to recognise that this improvement is in comparison with standard ambulance/hospital admission cases. This is why it is important to ensure that rural and urban parts of Wales alike can benefit from our skills and expertise.
Will northern parts of Mid Wales and North-West Wales be losing service? Expand No. Nobody is losing a service. Northern parts of Mid Wales and North-West Wales will see an improvement – particularly overnight. Comprehensive evidence shows that more lives could be saved in these regions because of the service improvement. We will work with our NHS partners and representatives from your communities to monitor and evaluate this service improvement over the coming years. As part of the EMRTS Service Review, one of the recommendations is to develop a bespoke, regional rapid response vehicle provision for these areas. This would be an NHS service and is in addition to Wales Air Ambulance - so yet another service improvement.
When will these improvements happen? Expand With a significant opportunity to save more lives across Wales, Wales Air Ambulance and EMRTS will start working together immediately to plan and implement these recommendations. A new base facility should be achievable within the next few years.
How will this improve the air ambulance service? Expand We can attend more patients. This means more lives will be saved. Northern parts of Mid Wales and North Wales will get an overnight service closer to them, rather than relying solely on the current single overnight crew based in Cardiff. We are making better use of our resources and using your generous donations more effectively to benefit more people.
Why did a review need to take place? Expand An independent Review of our NHS partners revealed that there are opportunities to improve our service for patients across Wales. It was led by the Chief Ambulance Services Commissioner for Wales. The Review found that: Right now, we are not getting to around 2 to 3 people a day. These patients will be in a life or limb-threatening situation. People in northern parts of Mid Wales and North Wales do not have a localised air ambulance service overnight. They rely on a nighttime service from South Wales. The service’s highly skilled medical teams based in Welshpool and Caernarfon are underused. An NHS Wales committee called the Joint Commission Committee agreed that improvements should be made to the current air ambulance service in Wales.