Llais calls for meaningful public involvement of rural communities in future ambulance services plans

Earlier this week, we attended the latest NHS Wales Joint Commissioning Committee (NWJCC) meeting to raise the experiences, concerns and questions people have shared with us about work arising from Recommendation 4 of the Emergency Medical Retrieval and Transfer Service (EMRTS) review.   

Recommendation 4 was agreed as part of the NWJCC's decision on the future configuration of EMRTS. It committed to developing proposals for enhanced critical care provision in rural and remote areas, reflecting concerns raised by communities during the original engagement process about access to emergency care. Throughout that process, people were clear that they wanted to remain involved in shaping future arrangements, and we continue to emphasise the importance of honouring that commitment.  

The NWJCC has been considering options for the future delivery of ambulance services in rural areas, including both emergency responses and planned patient transport services. Following discussions at the meeting we attended on 22 September 2026, engagement with the public is now expected to begin during October.  

Llais has consistently made it clear that people must have a genuine opportunity to share their experiences and views before any future commissioning strategy is developed. We have contributed to discussions about the proposed engagement approach and have continued to highlight what people need from the process.  

While focus groups can provide valuable insight, they should not be the only way that people are able to participate. We believe engagement should be open to the wider public and should include a range of accessible ways to get involved, including both online and face-to-face opportunities, so that people from all communities can have their voices heard.  

It is also important that engagement is not limited to existing health board planning activities. The future of ambulance services is of significant public interest and the engagement process must be visible, accessible and sufficiently promoted so that people are aware of the opportunity to take part.  

During the NWJCC meeting this week, we asked how the engagement will be delivered, questioned whether the proposed timetable remains achievable given that planning work is still ongoing, and encouraged consideration of a review point during the engagement period to assess whether it is reaching a broad and representative range of people.  

We were encouraged to hear support from both Hywel Dda University Health Board and Powys Teaching Health representatives, making sure that rural communities have the opportunity to contribute to this work.  

We have also asked whether a public update will be issued to explain the revised timetable, the reasons for the delay to the engagement programme, and what people can expect next. Clear and timely communication will be important in maintaining public confidence and helping people know when and how they can get involved.

While we wait for answers to all of our questions, the NWJCC has shared that is also keen to consider what people have told health boards and other organisations about rural transport when taking part in other consultations and engagement activities. Transport in rural areas is something that people continue to raise when talking about healthcare services more widely and by reviewing what people have previously said, it will help make sure that a greater range of experiences and concerns are noted and reflected in the strategy. 

As the independent voice of people in health and social care in Wales, our role is to make sure people's views, experiences and concerns are properly heard and considered as plans develop. We will continue to work with partners so that the priorities of people living in rural communities help inform future decisions about ambulance and patient transport services.  

Corporate director of operations, Angela Mutlow, said:  

"People living in rural communities often have unique experiences of accessing urgent care and planned healthcare services, and those experiences must be part of the conversation as future plans are developed.  

“We want to see opportunities for people across rural Wales to contribute their views in ways that work for them. Clear information, meaningful engagement and genuine involvement will be essential if people and communities are going to have confidence in the process and its outcomes.” 

Has your care been affected?    

If you are affected by the proposed changes, we want to hear from you.    

You can tell us about your experience by completing our national survey, or by speaking directly with a member of your local Llais team. Whatever you choose, we're here to listen.    

Share your story online or contact your Llais local team to speak to a member of staff.