PFD report

Gwynne SAMUEL · Prevention of Future Deaths report

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Issued 17 Jun 2022•Gwent

Report record

Published report and response evidence

This page connects the concerns raised in this report with statements found in recipients’ published responses. A link shows a clear evidence connection; it does not assign responsibility.

View original report
Concerns
2

Raised in this report

Recipients
1

Named on the report

Responses found
1

Of 1 recipient

Stated actions
23

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

Select any concern, action or position to view the source wording.

Concerns raised2

  1. Delays in providing ambulances to patients assessed as serious Amber 2 cases
    Part of recurring concern: Delays in ambulance attendance
  2. Failure to account for the clinical ramifications of prolonged lying in elderly patients during ambulance categorisation
    Part of recurring concern: Unreliable ambulance call triage and re-triage
Responses linked to these concerns

Each statement is shown once, even when linked to more than one concern.

Actions described in response An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.14

  1. Action

    Use cohorting crews to offload patients delayed outside hospitals, releasing frontline vehicles for waiting community calls.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 September 2022.
  2. Action

    Monitor the three new falls MPDS code suffixes and review data to consider recommendations on differentiated priorities.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 September 2022.
  3. Action

    Review long-waiting patients through Clinical Support Desk clinical assessment and increase response priority when acuity warrants it.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 September 2022.

Respondent positions A position is what a recipient says about a concern when it does not describe a specific action.3

  1. Position

    New rosters will initially retain a relief gap because commissioners have not provided additional resources for 2022/23.

    Stated by Welsh Ambulance Services NHS TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Delays in providing ambulances to patients assessed as serious Amber 2 cases

Wider context from the report

“GS was an elderly gentleman who had suffered a significant fall. The time it took for an ambulance to arrive and convey him to hospital contributed to his death insofar that the development of an acute kidney injury, which compromised his treatment and general condition, was caused by a long lie. A report obtained from WAST indicated that GS had been categorised as an Amber 2, which I understand is an urgent clinical priority considered serious but not life threatening. Whilst I accept that there was no evidence that GS was in immediate peril, it would appear that the clinical ramifications of an elderly person lying for a long period of time are not taken into account during the categorisation process. Whilst I heard evidence, and understand, the pressures on the ambulance service during the pandemic and the inability to release emergency ambulances due to congestion in hospital emergency departments, the inability to provide an ambulance to a patient determined to be in a serious condition (Amber 2) for 12 hours, puts lives in danger and, as in this case, may contribute to their death. ”

Is this part of a recurring concern?

Yes — Delays in ambulance attendance.

Open source report

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Failure to account for the clinical ramifications of prolonged lying in elderly patients during ambulance categorisation

Wider context from the report

“GS was an elderly gentleman who had suffered a significant fall. The time it took for an ambulance to arrive and convey him to hospital contributed to his death insofar that the development of an acute kidney injury, which compromised his treatment and general condition, was caused by a long lie. A report obtained from WAST indicated that GS had been categorised as an Amber 2, which I understand is an urgent clinical priority considered serious but not life threatening. Whilst I accept that there was no evidence that GS was in immediate peril, it would appear that the clinical ramifications of an elderly person lying for a long period of time are not taken into account during the categorisation process. Whilst I heard evidence, and understand, the pressures on the ambulance service during the pandemic and the inability to release emergency ambulances due to congestion in hospital emergency departments, the inability to provide an ambulance to a patient determined to be in a serious condition (Amber 2) for 12 hours, puts lives in danger and, as in this case, may contribute to their death. ”

Is this part of a recurring concern?

Yes — Unreliable ambulance call triage and re-triage.

Open source report

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Use cohorting crews to offload patients delayed outside hospitals, releasing frontline vehicles for waiting community calls.

Verbatim wording from the response

“To further mitigate the risk significant hospital delays are causing the service, cohorting crews provided by a private provider are being used to care for patients delayed outside Morriston and the Grange Hospitals while specific funding remains available.”

Source location

Response from Welsh Ambulance Services
Page 11 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Monitor the three new falls MPDS code suffixes and review data to consider recommendations on differentiated priorities.

Verbatim wording from the response

“The recent update to ProQA (the system for monitoring data within MPDS) released on 10th May 2022 has split the MPDS code suffix relating to falls on the ground or floor and added time targets as below:”

Source location

Response from Welsh Ambulance Services
Page 3 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review long-waiting patients through Clinical Support Desk clinical assessment and increase response priority when acuity warrants it.

Verbatim wording from the response

“The Medical Prioritisation Dispatch System (MPDS) does not provide a determinant code based on age within Protocol 17 (falls) which would prevent a specific prioritisation change for elderly patients. The principal role of the Clinical Support Desk (CSD) Clinician is to provide additional clinical triage, advice and support to patients to ensure that they can access the most clinically appropriate care for their urgent and emergency healthcare needs, commonly known as Hear and Treat (H&T). In addition to this principal role, the CSD also undertake a range of other clinical functions in pursuance of maximising patient safety for those awaiting an emergency ambulance. This includes reviewing long waiting patients to maintain patient safety.”

Source location

Response from Welsh Ambulance Services
Page 2 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review post-fall patient guidance and immobility risks through the Older Persons Improvement Group, then suggest improvements.

Verbatim wording from the response

“This has been delayed due to high levels of escalation within the organisation. However, it will be essential to seek opportunities to increase the levels of utilisation of falls resources, ensuring we are able to maximise response capacity across Wales. The newly formed Older Persons Improvement Group (OPIG), will conduct a review of the guidance provided to patients following a fall, consider the risks associated immobility and will suggest possible improvements, as part of the newly formed group, due to meet in August 2022.”

Source location

Response from Welsh Ambulance Services
Page 3 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Use shorter-term forecasting and quarterly performance reports to develop mitigating action plans when performance is forecast below requirements.

Verbatim wording from the response

“Seasonal planning including forecasting As well as utilising the services of ORH in longer term demand and capacity modelling, the Trust also commissions services from Optima who use simulation models which can predict output performance based on a range of input assumptions.”

Source location

Response from Welsh Ambulance Services
Page 11 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Refer categorisation of elderly patients affected by prolonged immobility after falls to the Clinical Priority Software Advisory Group.

Verbatim wording from the response

“The categorisation of elderly patients who suffer falls and are more likely be affected by the risks associated with lengthy periods of immobility, will be referred to the Trust’s Clinical Priority Software Advisory Group.”

Source location

Response from Welsh Ambulance Services
Page 2 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Operate the Clinical Safety Plan to dynamically prioritise patients with the most serious conditions when demand exceeds available resources.

Verbatim wording from the response

“Clinical Safety Plan”

Source location

Response from Welsh Ambulance Services
Page 10 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Continually review and update dispatch guidance for falls and frailty responders.

Verbatim wording from the response

“CSD clinicians have the ability to change the responding priority of an incident based on a secondary clinical assessment, this includes increasing the priority where the patient’s clinical acuity indicates this is appropriate. Dispatch guidelines regarding falls and frailty responders are continually reviewed and updated to ensure maximum utilisation of this valuable resource, part of the CSD role is to provide support to falls assistants following an initial assessment to ensure the correct outcome is reached.”

Source location

Response from Welsh Ambulance Services
Page 2 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Provide enhanced Clinical Desk capacity for targeted telephone advice to patients awaiting responses, including pressure-ulcer prevention and reduced immobility.

Verbatim wording from the response

“Enhanced Clinical Desk capacity has been introduced with the Clinical Contact Centre, which ensures patients receive targeted advice when waiting for a response including advice in relation to pressure ulcers and reducing the period of immobility. This is provided as part of the telephone triage and assessment.”

Source location

Response from Welsh Ambulance Services
Page 2 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Maintain unrestricted voluntary overtime availability for operational and clinical staff.

Verbatim wording from the response

“Voluntary overtime remains available for all operational/clinical staff across the Trust without financial restriction and whilst uptake has reduced in recent months, largely as a result of the current workplace experience, we continue to see in excess of 5,000 hours per week being worked. Controls to restrict the overall spend on overtime may need to be introduced as the year proceeds should the financial position require it.”

Source location

Response from Welsh Ambulance Services
Page 11 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Operate the Operational Delivery Unit to monitor real-time performance inhibitors, maintain situational awareness and coordinate mitigation across the unscheduled-care system.

Verbatim wording from the response

“The Operational Delivery Unit (ODU) acts as a central hub providing coordination for the Welsh Unscheduled Care System with a link between the Trust, Welsh Government, and all the Health Boards through a system-wide view.”

Source location

Response from Welsh Ambulance Services
Page 12 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Recruit and train additional staff to increase operational response capacity across Wales.

Verbatim wording from the response

“The ORH concluded that bridging the gap would require an investment of 263 staff on a full time equivalent (FTE) basis across Wales. The Emergency Ambulance Services Committee (EASC) agreed to invest in the Trust, over a two year period – 2020/21 and 2021/22, and close the “relief gap”, while it was agreed re-rostering would help improve the alignment and mix of resources allied to patient demand.”

Source location

Response from Welsh Ambulance Services
Page 6 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop and submit the Transition Plan seeking investment and setting out internal efficiency and delivery-model changes.

Verbatim wording from the response

“The Trust is committed to doing all that it can to reduce clinical risk, improve patient care and outcomes, ensuring that patients get the right service, in the right place, every time. The data in support of this statement shows that there is much more to do, with some actions within the Trust’s control, and many which are outside of its control.”

Source location

Response from Welsh Ambulance Services
Page 13 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Implement new demand-aligned rosters across Wales, incorporating the identified additional single-staffed-car capacity.

Verbatim wording from the response

“In the same time period, the Trust agreed to take steps to reduce abstractions due to sickness absence, to increase ‘hear and treat’ rates (where patients are triaged and given advice rather than deploying an ambulance) to 10.2% and to implement new rosters across Wales.”

Source location

Response from Welsh Ambulance Services
Page 6 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

New rosters will initially retain a relief gap because commissioners have not provided additional resources for 2022/23.

Verbatim wording from the response

“The four working parties have now concluded, and it is anticipated that the new rosters will be implemented between September and November 2022. As outlined above, by aligning rosters more closely with demand patterns, this will have the equivalent impact of an increase of 72 WTE.”

Source location

Response from Welsh Ambulance Services
Page 12 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Current demand pressures mean the Trust is unlikely to send responses or act differently within the newly assigned MPDS time targets.

Verbatim wording from the response

“There have been discussions at the National Ambulance Service Medical Executive Directors Group (NASMED) as to whether there should be further MPDS code suffixes for falls longer than two hours. NASMED has also highlighted the issue relating to calls just inside a time target window and calls where there is no further contact as the call does not automatically change if the call falls outside the MPDS code suffix window therefore there will be some patients disadvantaged for not calling back.”

Source location

Response from Welsh Ambulance Services
Page 3 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

The Trust cannot insist on discrete system actions; substantial resourcing and policy direction depend on Welsh Government and other system partners.

Verbatim wording from the response

“While significant collaborative work continues to be undertaken on these issues, there is little that the ambulance service can fundamentally do to insist on discrete actions, beyond lobbying and highlighting the very significant patient safety concerns which arise, particularly from extended waits outside hospitals, which inevitably also result in excessive waits for those patients awaiting help in the community.”

Source location

Response from Welsh Ambulance Services
Page 14 · response
Published 20 September 2022

Open published response

Other statements in published responses

These actions and other statements could not be clearly connected to one concern in this report.

Recipient-stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.9

  1. 1

    Continue discussions with commissioners and government regarding funding for the Transition Plan.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 September 2022.
  2. 2

    Work with internal, external and Health Board stakeholders to enhance Falls Assistant provision.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 September 2022.
  3. 3

    Operate the Resource Escalation Action Plan to identify service pressure and guide short-term response decisions.

    Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 20 September 2022.
  4. 4

    Operate the Clinical Response Model, which prioritizes immediately life-threatening calls while reflecting population demographics and service geography.

    Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 20 September 2022.
  5. 5

    Disseminate patient-safety risks, service pressures and mitigation measures through formal reports, correspondence, stakeholder briefings and media communications.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 September 2022.
  6. 6

    Develop and operate an attendance-management improvement plan to improve attendance and support staff returning to work.

    Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 20 September 2022.
  7. 7

    Provide a national Falls Assistant response service, including day coverage in each Health Board area and two additional night vehicles.

    Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 20 September 2022.
  8. 8

    Conduct a Quality Improvement Workshop to identify and prioritise tests of change for better falls-resource utilisation and response capacity.

    Stated by Welsh Ambulance Services NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 20 September 2022.
  9. 9

    Use four reviewed falls MPDS codes to enable Falls Assistants to attend without clinical triage where appropriate.

    Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 20 September 2022.

Recipient positions A position is what a recipient says about a concern when they do not describe a specific action.1

  1. 1

    The Trust could not deploy patient-cohorting arrangements in North Wales because suitable accommodation and funding were unavailable.

    Stated by Welsh Ambulance Services NHS TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Continue discussions with commissioners and government regarding funding for the Transition Plan.

Verbatim wording from the response

“Despite the proposals being put forward by the Trust, to-date the Transition Plan remains unfunded although, at the time of writing, discussions continue with commissioners and government.”

Source location

Response from Welsh Ambulance Services
Page 14 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Work with internal, external and Health Board stakeholders to enhance Falls Assistant provision.

Verbatim wording from the response

“Within 2021, the Trust successfully awarded a contract to provide a National Falls Assistant Service with at least one Falls Assistant (for 12 hours per day) in each Health Board area, to St John Cymru Wales. A total of eight Falls Assistants operate by day. The Quality Improvement Team are currently working with various stakeholders both internally and externally to further enhance the Falls Assistant provision. This includes the Operations and Clinical/Medical Directorate along with Health Board Partners. We have introduced a further two vehicles by night (funded by WAST) which is currently funded up to and including the 31st March 2023. There are a total of 10 Falls Assistants available per 24 hour period across Wales.”

Source location

Response from Welsh Ambulance Services
Page 2 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Operate the Resource Escalation Action Plan to identify service pressure and guide short-term response decisions.

Verbatim wording from the response

“Resource Escalation Action Plan (REAP)”

Source location

Response from Welsh Ambulance Services
Page 10 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Operate the Clinical Response Model, which prioritizes immediately life-threatening calls while reflecting population demographics and service geography.

Verbatim wording from the response

“Each ambulance service has a response model that supports the categorisation given to each call (irrespective of which prioritisation system is used). That response model and the decisions made will reflect the demographics of the population and the geography being served by that individual ambulance service. In 2015 the Welsh Ambulance Services NHS Trust introduced its current Clinical Response Model (the Model), which removed timed targets for all but those patients with immediately life-threatening illnesses or injuries. The Model underwent a trial period before being approved by the Welsh Government and fully implemented by the Trust.”

Source location

Response from Welsh Ambulance Services
Page 1 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Disseminate patient-safety risks, service pressures and mitigation measures through formal reports, correspondence, stakeholder briefings and media communications.

Verbatim wording from the response

“The leadership team of the Trust has taken every opportunity to escalate concerns across the system over a period of months.”

Source location

Response from Welsh Ambulance Services
Page 13 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop and operate an attendance-management improvement plan to improve attendance and support staff returning to work.

Verbatim wording from the response

“This notwithstanding, absence rates remain stubbornly high although these are not out of kilter with other ambulance services across the United Kingdom. As a result, an extensive attendance management improvement plan has been developed with a range of measures aimed at improving attendance and supporting our people back to work. However, the “moral injury” reported by staff remains equally high, as the environmental stress of working under sustained and relentless pressure takes its toll.”

Source location

Response from Welsh Ambulance Services
Page 8 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Provide a national Falls Assistant response service, including day coverage in each Health Board area and two additional night vehicles.

Verbatim wording from the response

“Additionally, in 2018, Working in partnership with St John Cymru Wales, the Trust introduced the role of the Falls Assistants (FA). The FA’s predominantly provide a response to patients who have no injuries or where there is a concern for welfare. However, they are able to respond to patients with other medical/frailty presentations, or if this is an injury. This decision will often be supported by a clinical triage and assessment by a clinician, over the phone, prior to allocation. The aim of this new level of response was to ensure those patients often presenting with lower clinical acuity, were provided with a timely response to reduce the risk of further harm.”

Source location

Response from Welsh Ambulance Services
Page 2 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Conduct a Quality Improvement Workshop to identify and prioritise tests of change for better falls-resource utilisation and response capacity.

Verbatim wording from the response

“The Trust continues to work with partners to further expand the model, to ensure patients are able to receive a timely response. In December 2021 the Trust undertook a review of the Medical Priority Dispatch System (MPDS) codes for Falls to determine if there were opportunities to improve the timeliness of response. Following a review, four codes were identified as suitable for Falls Assistants (non-registered, in some areas St John Service) to attend without the need for Clinical Triage, thus reducing the requirement to send an Emergency Ambulance. Furthermore, improvements are actively being considered to improve utilisation of resources and support patients who are waiting for a response. A Quality Improvement Workshop has been prioritised for August 2022, with representatives from across the organisation to identify tests of change and prioritise improvements.”

Source location

Response from Welsh Ambulance Services
Page 3 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Use four reviewed falls MPDS codes to enable Falls Assistants to attend without clinical triage where appropriate.

Verbatim wording from the response

“The Trust continues to work with partners to further expand the model, to ensure patients are able to receive a timely response. In December 2021 the Trust undertook a review of the Medical Priority Dispatch System (MPDS) codes for Falls to determine if there were opportunities to improve the timeliness of response. Following a review, four codes were identified as suitable for Falls Assistants (non-registered, in some areas St John Service) to attend without the need for Clinical Triage, thus reducing the requirement to send an Emergency Ambulance. Furthermore, improvements are actively being considered to improve utilisation of resources and support patients who are waiting for a response. A Quality Improvement Workshop has been prioritised for August 2022, with representatives from across the organisation to identify tests of change and prioritise improvements.”

Source location

Response from Welsh Ambulance Services
Page 3 · response
Published 20 September 2022

Open published response

Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

The Trust could not deploy patient-cohorting arrangements in North Wales because suitable accommodation and funding were unavailable.

Verbatim wording from the response

“To further mitigate the risk significant hospital delays are causing the service, cohorting crews provided by a private provider are being used to care for patients delayed outside Morriston and the Grange Hospitals while specific funding remains available.”

Source location

Response from Welsh Ambulance Services
Page 11 · response
Published 20 September 2022

Open published response
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Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026