Explainer

Welsh Ambulance Service: Why the army won't solve the current crisis in Wales

The health service saw its worst ever A&E waiting times in August. Credit: PA
  • By ITV Wales Journalist Kat Clementine

The ambulance service in Wales is "gridlocked" while suffering the strain of the highest number of life-threatening calls, according to the latest figures.

"All the wrong records keep getting broken", according to the Welsh Conservatives as the health service saw its worst ever A&E waiting times in August.

The Welsh Ambulance Service, which is seeking help from the military for the third time since the pandemic began, also recorded its second worst response times to the most urgent “red” calls.

But will calling in the army be enough to help the ambulance service, and is it the right solution to the ongoing crisis?

Calls to declare an ambulance emergency were rejected on Wednesday

What can the army do to help paramedics?

Army medics can deliver first aid and treat patients on the scene. A paramedic can respond to a 999 call and drive with blue lights to get to the patient as quickly as possible.

However, paramedics must stay with the patient in the cab of the ambulance at all times if the patient needs to be transported to hospital.

That means the army personnel will then be in charge of driving the ambulance - but they are not blue-light trained so cannot use the sirens or drive at speed.



'We're not a babysitting service - we're an emergency service'

Brecon-based ambulance technician, Paul Amphlett, doesn't think bringing in the army is the right solution.

"I respect the army, they do a wonderful job," he said.

"But bringing the army in isn't going to solve the problem. The patients are going to be coming in to the hospitals because they'll obviously be helping out to pick these patients up, but they're still going to be stuck in the car parks, we're still going to be waiting with them, babysitting them, so it really isn't going to solve the problem overall.

"The problem is further up in the system."

The medic, with 35 years of experience, said the current situation - and staff morale - is the lowest he has ever seen.

"We're picking up routine patients and Covid patients, taking them to hospital and then we're stuck in hospitals for six, eight, even 12 hours.

"I had a patient with me last week that was on the bed in the ambulance with me for 12 hours because we couldn't offload her into the hospital.

"It's not fair to the patients and it's not fair to the hospitals either. It's gridlocked at the moment.

"The system isn't working from inside. Social care is failing. There's patients stuck in hospitals that can't go out into the community."

Mr Amphlett said he - and the rest of the staff at his ambulance station - are at their "wits end".

"We want to be out there treating patients, fetching them to the hospitals for them to be offloaded and then go back out. But that just isn't happening.

"Mr Drakeford wants more ambulances on the road, but to be honest we're not a babysitting service - we're an emergency service."

"He needs to look on, it's a bigger problem."


Why are things so bad for the ambulance service at the moment?

Rising coronavirus cases, coupled with extra demand from seasonal flu on top of the usual pressures during colder months signals a "tough" winter ahead for the ambulance service.

The Welsh Ambulance Service said it wants to "get a head start" on a difficult few months ahead.

Darren Hughes, director of the Welsh NHS Confederation, which represents health boards, said: "There’s no doubt that coronavirus continues to have a significant impact on the delivery of health and care services across Wales.

“Rising cases have compounded existing pressures on services, meaning some difficult decisions have had to be made as many services are under more pressure now than they were at the height of the pandemic.

"Staff are doing all they can to continue delivering care for those who need it most and are exhausted after a challenging 18 months."


What help is needed to alleviate pressure on the ambulance service?

Shadow Health Minister Russell George MS, who led a Welsh Conservative debate in the Senedd on the crisis in the ambulance service, said ministers in power "must accept there is a problem" in order to solve it.

Dr Tim Rogerson agreed that the army won't be able fix the problem

Dr Tim Rogerson, a consultant with Aneurin Bevan University Health Board, tweeted that the UK doesn't need the army for ambulances or tents outside emergency departments.

He said: "We need every ambulance able to offload on arrival, adequate emergency department staffing and every patient to leave the emergency when referred… rather than hours or days later.

"There are lots of analogies but if the bath tub is full - make the plug hole bigger and more effective. Don’t make more taps or the bath have bigger sides!"


What is the Welsh Government doing to help solve this crisis?

Wales' Health Minister, Eluned Morgan, told the Senedd she is "absolutely taking responsibility" for the situation.

In a debate where the Welsh Government fell short of declaring an ambulance emergency but did call on military assistance, she said: "We've heard everybody this afternoon talk about the way the whole system is integrated that one path affects the other.

"So we're trying to manage all of those systems to understand and to make better those connections and to make sure that we can see that flow, and understand that that complicated set of arrangements that exist."

The Welsh Government said it has recently provided the NHS with an additional £240m to support plans to recover from the Covid pandemic and cut waiting times.

A spokesperson said: "There were more emergency ambulance calls in August 2021, than in any other August, since comparable data was first collected in October 2015.

"The proportion of all calls that were immediately life-threatening (red calls) was also the second highest since call handling practices were updated in May 2019.

"We encourage people to consider the best options for care, and not necessarily head to their local emergency department. To get the right care, first time people can also use the online 111 service and their local pharmacist where appropriate."