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HIW review of the Welsh Ambulance Service finds handover delays, call centre staffing levels and staff training are causes for concern

Delays caused by hospital handover, resulting in reduced ambulance availability, are a frequent occurrence, a Healthcare Inspectorate Wales (HIW) review of the Welsh Ambulance Services Trust (WAST) has found.

These delays have a significant impact on the ability of the service to respond to demand, increasing the risk of poor outcomes for patients. 

The review also found that a pressurised and stressful working environment was having a negative impact on staff well-being within the Trust’s Emergency Medical Service Clinical Contact Centres (EMSCCCs), with inadequate staffing levels impacting on the safe delivery of the service. Staff also raised concerns with HIW that the training and support they received needed to be improved, in order to carry out their roles effectively. 

The findings are highlighted in a report published today [30 September 2020] by HIW, following its review of Patient Management Arrangements within the three EMSCCCs. The review fieldwork was carried out prior to the COVID-19 pandemic, which has delayed the report’s publication.

The review assessed how patients are managed by the Trust’s EMSCCCs, from when a request for an ambulance is received to the point where the ambulance arrives at the scene. The review also considered how staff working within the EMSCCCs are resourced and supported to undertake their relevant roles. 

The EMSCCC staff told HIW that staffing levels were impacting on service delivery and staff morale and well-being, however, the review also recognises that WAST has made efforts to increase workforce capacity. With regard to training, HIW was told that many staff felt they needed more training to be more effective in their roles.

The review also found a strong team ethos in what is a stressful environment, with staff striving to deliver services, often in extremely difficult circumstances. The review highlights the impact that delays in ambulance to hospital handovers have on the service, limiting available ambulance resource, and its ability to respond to emergencies. Concerns were also highlighted with the consistency of incident reporting, with a need for the Trust to ensure a consistent understanding of what constitutes a reportable incident. 

Alun Jones, the Interim Chief Executive of Healthcare Inspectorate Wales, said:

Our review makes 27 recommendations on how WAST might be able to improve its service. 

We found that delays in patient handover between ambulances and hospital were a regular occurrence, limiting ambulance resource and affecting the Trust’s ability to respond in a timely way to demand. This can have a detrimental impact upon outcomes for patients and is an issue that the Trust needs play its part in resolving. 

Whilst it is clear that staff are working hard, often in difficult and challenging circumstances, our review has found that more can be done by WAST to focus on the well-being of its staff, and in ensuring that they are equipped to carry out their roles more effectively. 

We hope that the findings from this review will help improve the quality of the service that it provides.

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