PRESSURES in unscheduled care system and long handover delays at emergency departments are causing increasing risks, a meeting heard.

Board members at the Welsh Ambulance Service NHS Trust held a bi-monthly meeting on July 29 where they heard how two main risks had scored quite highly following a recent review.

This included being unable to attend patients in the community who require see and treat, which was given a risk score of 25, and patients delayed on ambulances outside A&E departments, which was also given a risk score of 25.

Keith Cox, board secretary, said these two main risks were ‘still there and still scoring highly’ but continues to be reviewed regularly.

He told members that ‘there is more to be done here’.

In the report shown to members, the risk of being unable to attend patients in the community has a target score of 10.

In terms of patient delays on ambulances outside of A&E departments, this too has a target score of 10.

The measures in place to mitigate the risks for these two risks include Welsh Government target that ambulance handover at emergency departments will be no longer than 15 minutes, a piloted hospital ambulance liaison officer at major emergency departments and a resource escalation action plan.

Also in place is alternative pathways, minimising the service through hear and treat and 111 etc, working to the well-being and future generations act, a demand management plan and an operational delivery unit.

Board members also discussed developing the Trust’s strategy with the development of a new strategy group which will look at longer term ambitions.

The report stated: “Whilst the COVID-19 pandemic has clearly been very disruptive to many elements of the Trust’s plans nevertheless it has also quickened progress in some areas. It has also provided a real sense of urgency across the system in terms of improving the urgent and unscheduled care system for the benefit of patients as organisations seek to recover and reset.”

Work began earlier this year to discuss a longer-term strategy to transform services for patients.

Members were told how this is an informal and flexible group but will use a seven-stage framework.

Although the work is in the early stages, some key next steps include discussions with staff through a series of autumn road shows, partnerships with health boards, additional clinical and planning resources and the development of a small strategy development group with trade unions.

Member Martin Turner said this is ‘more of a journey than a destiny’ and requires partnered working as there is ‘a lot we can improve on’.

He added that changes are not just about what they change, but the impact on others like GPs.

Jason Killens said everyone is anxious to see a pace in delivery but this group has only met twice and there is ‘much more that will come’.