Keeping you informed: Emergency Medical Retrieval and Transfer Service (EMRTS) review, service change and next steps

Background

After a period of consultation and engagement, The NHS Wales Joint Commissioning Committee (JCC) took a decision last year to consolidate the EMRTS bases at Welshpool and Caernarfon into a single site in North Wales. 

We know that this worried a lot of communities, particularly in Mid and North Wales, as you were concerned about what emergency transport provision would be in place in the future, and how it would serve all the communities across Wales. 

This decision was later challenged through a Judicial Review, a legal process that allows a court to review whether a public body has acted lawfully in making a decision. 

The review concluded earlier this year (June), and an appeal was also dismissed in October; meaning the Judicial Review  process finished at that point.

 

Why we’re sharing this update

Since the legal challenges ended, we’ve been hearing growing concerns from communities about what's happening next, especially around Recommendation 4 of the EMRTS Review, which proposed the development of an enhanced road-based critical care service for rural and remote areas.

This is clearly a topic that matters deeply to many, and it’s understandable that communities want to know what’s happening next, and how they will be involved.

So, we wanted to set out what we are hearing from people, what we understand to be happening next, and what we are doing to represent the interests of people and communities.

 

What was Recommendation 4 about?

Recommendation 4 was approved by the Joint Commissioning Committee at the same time as its decision to consolidate the EMRTS bases into a single site in North Wales. 

Recommendation 4 was to develop a commissioning proposal, a formal plan, setting out how  a bespoke road-based enhanced and/or critical care service in rural and remote areas could be designed and delivered.

The principles agreed by the Committee include:

• This is a direct response to concerns raised during public engagement about emergency health provision in rural and remote areas.
• It is additional to the highly specialised EMRTS service, not a replacement.
• No changes to existing base locations would be made until the bespoke service referred to in Recommendation 4 was in place.
• The service would be provided from two additional bases in rural areas, bringing the number of bases available to EMRTS from 4 to 5.
• The location of these bases would be modelled to ensure they are in the ideal locations to maximise their effectiveness.
• The Joint Committee will agree the scope of the work and establish a Task and Finish Group to develop an implementation plan.

Early thinking shared in the original papers suggested this could involve road-based rapid response vehicles and additional bases in rural areas. 

 

What's been happening 

While the Judicial Review and subsequent appeal were ongoing, both the Committee and the Task and Finish Group paused their work on all recommendations.

We understand this decision. It would not have been right to assume the outcome of the legal process or to continue planning without knowing whether the review would be upheld.

Some people have told us they wanted regular, proactive updates from those developing the plans, so they knew what was happening, even if it was just to confirm that work was still on pause during the appeal. 

We have raised this directly with members of the Joint Commissioning Committee team, who have now agreed to provide more frequent and proactive communications. This will help everyone understand what is happening, why decisions are being made, and what the next steps will be.

 

Our role

Our role is to make sure people’s voices are heard and that decisions affecting health and social services are transparent and accountable.

We supported communities to share their views during the original consultation and continue to monitor developments closely. 

We will keep asking the questions that matter to you and make sure that commitments made during the review process are taken forward by working closely with affected communities.

We also want to make sure that any changes are communicated clearly and that people understand what emergency transport provision will look like in the future. 

We’re committed to working collaboratively with the Joint Commissioning Committee and its working groups so that communities are kept involved in service developments, have clear, timely information and confidence in the future of emergency transport services.

 

What’s happening now

There is a Joint Commissioning Committee meeting coming up on Tuesday 25 November at 9:30am, which will be held in public. 

This is the first committee meeting since the Judicial Appeal ended. One of the papers being considered is the Emergency Medical Retrieval and Transfer Service Update. This paper is for discussion only; no decisions will be made at this meeting.

We have looked at the paper and, while we welcome the progress in restarting, we want to know more about when the new recommendation 4 proposal will be developed and delivered, and how this fits with the earlier commitments and decisions regarding base closures. We have raised these matters with the team at the JCC and will do so again with the Committee at the meeting.

We have also stressed to the team at the JCC that communities would expect any new service, service changes, or improvements to be designed with community views at their heart and in line with statutory guidance. Listening to and responding to these views is essential for creating solutions that truly meet people’s needs.

 

If you want to watch the meeting yourself on 25 November, you can register by emailing [email protected].

We remain committed to keeping you informed and making sure your voice is heard.