Paramedics have told an inquiry into the Welsh ambulance service of a 'general culture of fear', with staff feeling they have little or no support from management. Some said morale was 'at rock bottom'. The report blames a 'fundamentally flawed' relationship with the local health boards.
The Wales Ambulance Service Trust is currently engaged as a provider with its partners and suppliers, although the arrangements are fundamentally flawed. There are no tangible contracts or service level agreements in existence which ensure demand for services are understood, benchmarked and planned ... Further, the current arrangements are blurred with an apparent absence of accountability for ensuring resources are matched to demand effectively.
The report from Professor Siobhan McClelland was commissioned by the Welsh Government because the ambulance service has consistently missed its targets for responding to emergency calls. Prof McClelland puts forward three alternatives for reorganising the service to improve its performance.
- Turn it into a special health board, giving it an equal relationship with regional health boards.
- Keep the present relationship with health boards but spell much more clearly what will be delivered.
- Dissolve the all-Wales service and hand responsibility for emergency ambulances to health boards.
The report says health boards must stop relying on emergency ambulances to plug gaps in the provision of non-urgent patient transport. On ambulances queueing outside A&E, it says 5,000 hours of emergency cover was lost in March alone as a result of these delays.