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Changes to ambulance response times

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ambulance2THIS WEEK, The Herald is investigating ambulance response times in Wales after a local member of parliament raised concerns after receiving comments from paramedics who have said the ambulance service is ‘not fit for purpose’.

A new ambulance system was implemented in October 2015, after requests had been made to create a system that places calls into different categories; ‘red, amber, or green’, with red calls considered life-threatening. This new system is a step away from the original ‘Category A, B, C’ calls, and the Welsh Government continue to set a target that would see 65% of Red calls receiving a response within eight minutes.

Red calls refer to immediate lifethreatening calls where someone is in imminent danger of dying, such as a cardiac arrest. Amber calls are for patients who may need treatment at the scene or fast blue light transportation to a hospital. Green calls are calls of a non-serious nature, which can be managed by other services, including healthcare advice.

The Welsh Ambulance website tells readers that they are moving away from time-based targets, and looking more closely at the quality of what they do once they arrive.

The site says the new changes place the patient at the very centre, explaining: “The changes will clearly identify those patients who require an immediate life-saving response, and these patients will receive the highest priority response in the fastest time possible.

 

“All other patients will receive a bespoke clinical response based on their condition rather than a generic response based solely on a time standard.”

MP’S CONCERN

Plaid Cymru MP Jonathan Edwards expressed concerns on the changes to ambulance response times, explaining: “In theory, the new system introduced by the Labour government could mean a pensioner falling and breaking their hip but unless there is a risk of heart attack or stroke then an ambulance has no time target to arrive. This could lead to a whole host of problems… and could have serious consequences.”

With this new system, targets are only set for urgent red calls, so performance data subject to targeting is unavailable for less urgent amber and green calls.

Leader of the Welsh Liberal Democrats, Kirsty Williams AM, told the Herald: “This new targeting regime may make life easier for Labour Ministers but in reality people are being left in the dark as to how well their ambulance service is actually performing.”

Although the Welsh government continue to set a target that 65% of all red calls will receive a response within 8 minutes, the public have no way to find out how fast ambulances reach other, less urgent calls.

Kirsty Williams continued: “A rugby player with a broken leg, or an older person fallen down the stairs, could be waiting for hours upon hours, and we would have no idea.

“Even if targets aren’t applied to these less urgent calls, at the very least we should be able to see how quickly they’re responded to. People have the right to hold their Ministers to account, but this new regime amounts to a backwards step for transparency by Labour.”

Jonathan Edwards felt worried that the Welsh government were changing targets as they could not be met, claiming there was ‘more to the changing of targets than meets the eye.’

Over the last three years the target has been met only once.

Mr Edwards also questioned why the Welsh government’s target of 65% was lower than targets of 75% set in England and Scotland, feeling there was a ‘lack of ambition’ from the Welsh government.

Speaking of ambulance response changes in October 2015, Jonathan Edwards said: “Any observer would reasonably expect a government – irrespective of political hue – to want to raise standards and targets. With the Labour party, however, we have a Welsh Government that is scrapping targets – which were already less ambitious than the rest of the UK – when it can’t meet them.”

TARGETS NOT MET

Since the new system has been implemented, response time data has been made available on the Hywel Dda University Health Board, and the statistics show that the 65% target has still not been met.

The Herald contacted both the Hywel Dda Health Board, as well as the Welsh Ambulance Service, to see if they could enlighten us with their insight on the current issue.

A spokesperson for the Welsh Government explained to the Herald: “We totally reject these allegations.

“The new model, which was devised by clinicians, is designed to provide the best care and results for people in life-threatening situations and to improve outcomes for patients. The latest figures suggest it is making a difference to patients.

In December, there was a 15% increase in the proportion of people with an immediately life-threatening condition who received a response in eight minutes, compared with the same month in 2014 in a similar category, under the old system.

“In December, the average response time to patients in the new amber category – people who do not need immediate life-saving care – was just 11 minutes and four seconds, including for stroke patients. Evidence suggests that transporting these patients to the right healthcare facility within one to four hours will improve their outcomes. There has been no change in category under the new model for the level of response required for patients who have broken their hip.”

Jonathan Edwards’ concerns have been reinforced by ambulance workers, with one paramedic speaking out to state the new system only exists to appease the Welsh government.

Speaking anonymously, one paramedic spoke of the new system explaining: “The new clinical model is nothing more than yet another way to fraudulently manipulate responsetime performance figures in an attempt to pacify the Welsh Government and Welsh media.

“It makes no difference to the staff on the road other than an apparent tendency to code calls in the highest ‘red’ category based on proximity of a resource rather than clinical need.”

CALL CONCERNS

One of the main concerns is that prioritising calls based on the seriousness of the incident can prove difficult, with some incidents being categorised as not urgent enough; therefore not suggesting that a quick response time must be met by the ambulance service.

A second paramedic said: “The amber calls are too broad and don’t come across urgent enough for us to respond to quickly.”

With only the red category having a response time target of 8 minutes, the amber and green categories of calls do not have a target time, and implications are made this will affect how quickly patients receive emergency healthcare.

Jonathan Edwards MP continued to show his concerns saying: “I am gravely concerned by these comments, not least because the new target has still not been met for patients within the Hywel Dda area. If a government moves the goalposts and still can’t hit a target then there is a deeprooted problem that needs prompt investigation and remedy.”

 

A Welsh Ambulance Service spokesperson told the Herald they are trying to build a culture of integrity and partnership in the Welsh Ambulance Service, explaining: “This feedback is very disappointing especially when we are working very hard developing positive relationships with staff and their trade union representatives.

“While we strongly refute the suggestion that the clinical model is an attempt to manipulate performance data, we recognise that staff continue to face day-to-day challenges which, while frustrating, are not linked to the model, which is evidence-based and which is delivering positive benefits for our patients.

“We are absolutely committed to working in partnership with our staff and trade unions to resolve some of the operational challenges our teams face, and this includes further developing our mechanisms for listening to, and addressing staff concerns.”

The decision for the change in the new ambulance system came after a clinical review which was led by Dr Brendan Lloyd, medical director of the Welsh Ambulance Services NHS Trust.

The review found that there is no evidence to support that the eight minute response time, which was originally established in 1974 and has not been changed since, makes a positive difference to the outcomes of around 95% of patients accessing the ambulance service.

HERALD MEETS GETHING

The Herald met with The Deputy Health Minister for Wales, Vaughan Gething, to discuss his thoughts on the matter. Vaughan Gething explained: “The demands placed on our emergency ambulance service are more complex than ever before and are growing year-on-year. It is clear if we are to meet these demands and ensure the best outcomes for patients, we need to transform the way in which we deliver emergency ambulance services.

“The new clinical response model, which we will pilot in Wales, has been designed by Wales’ top ambulance service clinical leaders and is based on firm evidence. It is a move away from the system based solely on the eightminute response time target, which was introduced 42-years ago, to one which measures how successful our ambulance clinicians are in ensuring they have the most positive impact on clinical outcomes and people’s quality of life.

“We take very seriously the responsibility to have appropriate response times for those who need it, that’s why we changed the model, it is about people who need a fast response. The health board is in a better place than it was under the old model.

“I am confident these changes will improve patient experience. They will also make emergency ambulance services in Wales among the most progressive and transparent in the world.”

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Health

Werndale Hospital recognised for outstanding patient care in national award

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STAFF at Werndale Hospital near Carmarthen have been recognised for the quality of their patient care. 

The prestigious ‘Private Hospital Group of the Year’ award is presented to an organisation that has shown excellence in its delivery of care, commitment to the community and innovation within healthcare.

Werndale Hospital was also recognised for their initiatives to support staff in their career progression and wellbeing.   

The latest statistics show, 98% of patients at Werndale Hospital were satisfied with their overall level of care, 98% of patients would recommend their care to family and friends, and 98% of patients rated the nursing staff as excellent or very good. 

In addition, independent analysis of Circle hospitals’ hip and knee procedure outcomes of health improvement shows that Circle scored 8.4 versus an independent sector average of 7.8 in the hip category, and a score of 15.4 versus an independent sector average of 13.9 in the knee category.   

The award presented to Circle Health Group, owners of Werndale Hospital, in London in June, also noted the extraordinary contribution the teams at the hospital had made to the community. 

In 2021 alone, Werndale Hospital partnered with Air Ambulance Wales and raised £1,205 to support the charity’s work in the community.  

In addition to the charitable work, Werndale Hospital was recognised for it’s commitment to support staff through a series of wellbeing initiatives and career development opportunities. The judges were particularly impressed with the launch of the ‘Be Heard’ survey at the hospital.   

The survey looks to empower staff to feedback on everything from the working environment at the hospital through to their own career ambitions. Building directly on the feedback from this survey, the ‘Grow Your Own’ campaign was launched which supported staff to work towards specific qualifications from nursing degrees with partnered universities through to bespoke management programmes and MBA qualifications.   

As a direct result of this support for staff at what is a challenging time for healthcare workers, Werndale Hospital and Circle Heath Group were recognised as being a Top 20 Best Large Company to work for.   

At the heart of Werndale Hospital’s approach to treating patients is a commitment to the community they serve.  

 Paolo Pieri, CEO of Circle Health Group, said:  “The award is a testament to what an amazing year 2021 was for Werndale Hospital with considerable investment into the facilities and services on offer to patients in west Wales. I couldn’t be prouder of what our staff and doctors have achieved.”  

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Aberglasney Gardens delighted to win 2022 Trip advisor Travellers’ Choice Award

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ABERGLASNEY Gardens is thrilled to have been recognised by Tripadvisor as a 2022 Travellers’ Choice Award winner for being in the top 10% of attractions worldwide.

The Award recognises businesses that consistently deliver great service with the Gardens being rated ‘Excellent’ by 342 visitors.

The award celebrates businesses that have received great traveller reviews from around the globe on Tripadvisor over the last 12 months. As challenging as the past year has been, Aberglasney stood out by consistently delivering positive experiences to visitors.

Aberglasney’s Director of Operations Jim Stribling said: “We are delighted to have once again won an award from Tripadvisor. It is fantastic recognition for the team’s hard work and dedication. To rank among the top ten percent of those listed on Trip Advisor as one of the best places to visit is outstanding.

“We are grateful to all those who take the time to leave us a review after visiting. It is no cliché when I say all the team, be it in the gift shop, the gardeners, the tearooms and the administrative team, all take the reviews on board to help make a visit to Aberglasney the best possible experience for everyone.”

Tripadvisor, the world’s largest travel guidance platform, helps hundreds of millions of people each month become better travellers, from planning, to booking, to taking a trip. Travelers across the globe use the Tripadvisor site and app to discover where to stay, what to do and where to eat based on guidance from those who have been there before.

With more than 988 million reviews and opinions of nearly eight million businesses, travellers turn to Tripadvisor to find deals on accommodation, book experiences, reserve tables at restaurants and discover great places nearby.

As a travel guidance company available in 43 markets and 22 languages, Tripadvisor makes planning easy no matter the trip type.

“Congratulations to the 2022 Tripadvisor Travellers’ Choice Winners,” said Kanika Soni, Chief Commercial Officer at Tripadvisor. “The Travellers’ Choice Awards recognise the best in tourism and hospitality, according to those who matter most: your guests.

“Ranking among the Travellers’ Choice winners is always tough – but never more so than this year as we emerge from the pandemic. Whether it’s using new technology, implementing safety measures, or hiring outstanding staff, I’m impressed by the steps you’ve taken to meet travellers’ new demands. You’ve adapted brilliantly in the face of adversity.”

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Education

Council’s plan to expand bilingual education will be a gradual journey over 10 years

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Carmarthenshire County Council

CARMARTHENSHIRE County Council’s vision to increase bilingual education in Carmarthenshire will be a gradual journey over 10 years.

The Cabinet met yesterday (Monday, July 4) to discuss the Welsh in Education Strategic Plan (WESP), and emphasised that it was important to give all children and young people the opportunity to develop their Welsh language skills.

However, members stressed that families will still have a choice on the language in which their children will be taught over the next decade and after 2032.

The plan sets out how the council will develop Welsh language provision in schools based on the outcomes and targets set by the Welsh Government.

All councils across Wales have to submit 10-year Welsh language education plans to the Welsh Government in order to meet its target of one million Welsh speakers by 2050.

The outcomes include more nursery and reception children being taught through the medium of Welsh; more young people studying for qualifications in Welsh as a subject, and subjects through the medium of Welsh; increasing provision for learners with Additional Learning Needs; and increasing the number of teachers able to teach Welsh and through the medium of Welsh – with continuing support to develop staff through a comprehensive and flexible training programme.

The Cabinet said it was important for the council to provide more opportunities to be bilingual and referred to the various benefits it brings – from educational attainment to employability and health.

Cabinet Member for Education and Welsh Language, Cllr Glynog Davies said the aim was to meet and exceed the target set by Welsh Government on the percentage of Carmarthenshire pupils receiving their education through the medium of Welsh by 3032 (10-14%).

It included changing the language provision at 10 schools over the next 10 years creating an opportunity for a further 300 learners to be educated in Welsh.

He said: “We want to build on the progress made in early years education provision, and my ambition is clear – equal opportunities across the county.

“It is worth noting that we have the largest percentage 57.5 percent of nursery age children taught through the medium of Welsh. Immersion education is key to the strategy, and it is important that we continue to see an increase in the percentage of children transferring from the Meithrin groups to Welsh-medium education in the Foundation Phase.

“These early years are so important, the children are like sponges, absorbing information and absorbing a new language.

“We must then continue to see an increase in numbers in our reception classes, we say this even though we are the authority with the largest percentage (62.5 percent) of children receiving their education through the medium of Welsh.

“Children must continue to improve their Welsh when going from one school phase to another, and we need to make sure all children have the opportunity to pursue their secondary education through the medium of Welsh.

“At the same time, we need to give children and young people the confidence to use Welsh, in school and in the community. That’s what we want to see isn’t it, more and more using Welsh, hearing Welsh on the street. We need to develop and build on skills and confidence.”

Cabinet Member for Rural Affairs and Planning Policy, Cllr Ann Davies said: “I am extremely pleased to see this document and have a pleasure in supporting it. Working with young children, that is children under three-years-old, I can say that children pick up language very quickly, they absorb it, and the process is very different to learning a language. As they get older the process in the brain is completely different. I am pleased to see that there is an emphasis on early years, that is when we need to start.”

Cabinet Member for Resources, Cllr Alun Lenny said: “It is very important to state that there are many advantages to learning a language, obviously for careers, especially in health and social care where patients and clients must have a choice of language, it’s important particularly for older people, and young children, and people with dementia.

“The Chief Constable of Dyfed-Powys Police has stated he is keen for all his staff to speak a certain level of Welsh, so we have a duty here to support that.

“The advantages of being bilingual are multiple, socially and in the world of work, and this strategy is very much welcomed.”

The WESP has come back to the cabinet for discussion following feedback from the Welsh Government, mainly to include some additional data and detail. It will now be submitted to the Welsh Government for final approval. A public consultation was held last year.

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