A key target for ambulances to respond to the most urgent 999 calls within eight minutes, which has not been met in five years, will be ditched following a review.
Jeremy Miles, Wales' health secretary, announced a move away from the time-based target of responding to 65% of life-threatening "red" calls within eight minutes from July 1st.
The Welsh Government target was last met in July 2020, with 48% of 6,073 red calls receiving an emergency response in eight minutes in January this year.
Mr Miles said a clinician-led review found the eight-minute target, which has been the standard since the 1970s, is no longer appropriate nor fit for purpose.
In a statement to the Senedd on Tuesday, he explained the ambulance service will trial changes over the next year which will focus on outcomes rather than response times.
'No evidence'
A purple category – for cardiac and respiratory arrest – will be added, with the red category for major trauma, bleeding and cases where a person's condition could rapidly deteriorate.
Mr Miles said of the current eight-minute target: "There is no evidence it helps drive better outcomes. It does not support effective clinical prioritisation."
He added: "This means that precious ambulance resources are being dispatched to people who are less seriously ill and may not require emergency treatment or onward hospital care."
"And we measure success purely through the lens of response time in these examples. So, if an ambulance arrives in eight minutes and one second and the person survives – that would be regarded as a failure because the response time target was missed."
"But, perversely, if the ambulance arrived within eight minutes and the person unfortunately died – that would be regarded as meeting the target."
'Unacceptable'
Mr Miles said survival rates in Wales after an out-of-hospital cardiac arrest are less than 5%, compared with 9% in Scotland, 10% in England and far higher elsewhere in the world.
"This is not acceptable...," he told the Senedd. "We must aspire to do better and to match survival rates in European countries and some US cities."
The health secretary stated both the purple and red categories will be subject to time-based targets, with an average expected response time of six to eight minutes.
He detailed a focus on early CPR and defibrillation before announcing a group to review ambulance patient handovers, with around 27,000 hours lost due to delays in January.
Mr Miles told Senedd members: "We must have a significant improvement in ambulance handover performance to ensure ambulances are available to respond to 999 calls in the community and not stuck outside hospitals for hours on end."
'Largely ornamental'
Before the pandemic the median response time for red calls was four minutes and 30 seconds but at the beginning of this year the average was eight minutes and 17 seconds.
Most calls are "amber", for which there is no corresponding measure, but a further review will assess whether to introduce targets for the category which includes stroke symptoms.
The Senedd's health committee called for a review of the red target in a report published in August after taking evidence from the Welsh Ambulance Services NHS Trust.
Russell George, the Tory chair of the committee, welcomed the statement, adding: "But, of course, having targets in place is important – they're there to ensure accountability."
Plaid Cymru's Mabon ap Gwynfor also backed the change in direction, describing the red response time target as "largely ornamental" over the past half a decade.
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