EMRTS Service Review: Decision of the NHS Wales Joint Commissioning Committee

05 April 2024

Regular stakeholder update from Commissioning Director of Ambulance and 111 (Interim) , Stephen Harrhy:

I wanted to update you on decision of the NHS Wales Joint Commissioning Committee (JCC) – which has replaced the Emergency Ambulances Services Committee (EASC) from 01 April 2024 – following the meeting on Tuesday 23 April. The JCC met to consider the recommendations of the Emergency Medical Retrieval and Transfer Service (EMRTS) Service Review. As you are aware, the purpose of the Review was to look at how the service could be further improved to reach more people - where currently there are 2-3 people per day who need the service but do not receive it - and also to make more effective use of the clinical teams across Wales – some of whom are not used as much as they could be. This Review began afresh after the initial EMRTS Service Development Proposal was first received by the then EASC Committee in November 2022, the JCC Committee and I thank stakeholders for their patience during the time taken to ensure the work was carried out robustly. The JCC Committee recognised that the engagement process identified differing views on the ways in which the service could further improve.

In delivering improvement there is always a challenge in reconciling differing views into an agreeable way forward but there is clear common ground in finding the best solution to reach more people who need the service and make better use of the critical care expertise of the EMRTS teams. The JCC Committee, which comprises four Lay Members and seven Health Board Chief Executives, acknowledged there were different views from some members but arrived at a majority decision to accept the recommendations to merge Caernarfon and Welshpool bases into a new location in central north Wales, with an exact location to be decided at a later stage. The recommendations also included providing an additional bespoke road-based service for rural communities in direct response to what was heard during the Review’s engagement. It is expected that these changes will enable more people to benefit from the clinical expertise delivered by teams of this critical care service by reducing the current unmet patient need across the whole of Wales in every Health Board area. These changes will keep the same number of helicopters and teams but by organising the service operations differently, it also allows an improvement to night coverage where there is significant demand for this service, particularly in the north areas of Wales. These developments introduce night flying from North Wales beyond 8pm instead of just the Cardiff team having to cover the whole of Wales.

The service is delivered in partnership between the Wales Air Ambulance Charity and the EMRTS clinical teams of NHS Wales and the JCC Committee acknowledges the public passion for this service and the public interest on its future developments. I am grateful for all the responses submitted throughout the engagement and all the time and interest shown in the EMRTS Service Review. I appreciate that this decision may be disappointing for some citizens however the JCC Committee has given due consideration to these and is assured that this development will provide an improved service for population of Wales and that people who receive a service now will continue to receive a service. At the heart of this issue is a collective desire - between the public and stakeholders - to work together with the Charity and EMRTS - to make this great partnership service even better for communities in Wales as it continues to evolve so that more people can benefit from the clinical outcomes the service provides. Next steps, following this JCC Committee decision, will be to set out the implementation plan in more detail. This includes key milestones and timescales that will be reported back through the JCC Committee including the bespoke rural service with no changes to base locations expected to take effect until 2026.

This maintains the transparency that has been delivered throughout the Review. I am particularly grateful for the way in which the Charity and EMRTS have supported and contributed to the Review in what have been challenging circumstances for them given the uncertainty affecting their people and business planning. I am also grateful to Llais, the national citizens voice body for Wales, who advised on the engagement as well as NHS Wales colleagues who have helped deliver the all Wales engagement with citizens. As has been the case throughout the Review’s engagement, I am keen to continue listening to and working with public and stakeholders, NHS Wales colleagues, the Charity and Llais as we work through the next steps. I sincerely hope that everyone can continue to support the Charity that enables this life-saving partnership service to be delivered for everyone in Wales. I will be in touch again with further updates as the implementation progress and my sincere thanks once again for your continued interest on this matter although please let us know if you would like to be removed from this stakeholder distribution list at any time by emailing: nwjccasc@wales.nhs.uk 

Sincere thanks for your interest and contributions to the Review on this important service for Wales.

Stephen Harrhy
Director of Commissioning - Ambulance and 111 (Interim)