Thank you, Presiding Officer. I’m pleased to update Members on the outcome of the independent evaluation of the clinical response model for emergency ambulance services.

Members will know that the clinical response model pilot commenced on 1 October 2015. There was widespread agreement that the previous model was not supported by clinical evidence and made poor use of the emergency ambulance service. The new clinical response model set out to make the best use of our ambulance service and ensure that it prioritised people with the greatest clinical need.

I received clear clinical evidence from a review conducted by Dr Brendan Lloyd, the medical director of the Welsh ambulance services trust, to undertake this pilot. His advice was explicitly endorsed and supported by every other medical director in Wales.

When making the decision to approve the pilot for the new clinical response model, I directed the chair of the emergency ambulance services committee, which I’ll now refer to as EASC, to commission a robust independent evaluation. I’ve now received that evaluation report. Having considered the report’s findings and advice from EASC, the Welsh ambulance service and my own officials, I have decided to approve the substantive implementation of the new model with immediate effect.

In my written statement yesterday, I set out some of the key findings from the evaluation report. The report was supportive of the introduction of the new model and identifies a range of benefits from its introduction. It found that the new model has helped to deliver a service that is more focused on the quality of care that patients received and it has improved efficiency in the use of ambulance resources. The new model has provided additional time for call handlers to better assess patients and ensure that they get a response from the right type of clinician and vehicle in the first instance. It’s allowed the Welsh ambulance service to explore alternative ways of responding to calls, either over the telephone, known as ‘hear and treat’, or at the scene, which is known as ‘see and treat’. The number of calls ended through hear and treat has significantly increased since the beginning of the pilot. In December 2016 alone, the Welsh ambulance service was able to avoid 1,700 ambulance journeys through hear and treat. This was the highest monthly rate since the beginning of the pilot, and is a 70 per cent increase compared to October 2015. Similarly, there’s been a 9 per cent increase in the number of incidents that ended following a face-to-face intervention from paramedics at scene, without the need for that patient to be taken to hospital. In December 2016, over 3,000 patients were discharged through see and treat. So, those patients remained at home, and ambulance resources were released into the community without an unnecessary journey to hospital.

The Welsh ambulance service enhanced its clinical desk in November last year so that more calls can be resolved without patients going to hospital. It also provides improved clinical support to ambulance staff making on-scene treatment decisions.

Whilst these results are promising, there is, of course, scope to increase hear-and-treat and see-and-treat rates in Wales as we do remain behind other parts of the UK on these measures. I expect the Welsh ambulance service and health board partners to work with the chief ambulance services commissioner to take this matter forward.

One of the report’s recommendations was to keep call categories under constant review to ensure that patient experience and expectation is considered as part of our evidence-based approach. A year of operation now means more robust and real-time information for EASC to carry out this work in collaboration with the Welsh ambulance service to support improvements for patients. I know that accurate and easily accessible data is fundamental to understanding demand, and there is a clear need to improve data across the patient journey. So, the new model introduced a new suite of ambulance quality indicators. These provide a much broader view of the quality of care that is being provided by ambulance clinicians. I’ve been particularly encouraged by high performance levels against the seven clinical indicators being measured. This demonstrates that paramedics are delivering care that will make a real difference to patient outcomes. EASC is now working with the world-renowned Picker Institute Europe to improve measures relating to patient experience. And work is already under way to establish routine linking of data across the patient journey. This will allow us to analyse the impact on patient outcomes of interventions at each step of patient care.

Together, this work will help Welsh ambulance service AST and EASC to understand emergency ambulance services in ever greater detail and place interventions in the wider context of the patient’s journey through the unscheduled care system. This work will also inform the refresh of the AQIs later this year to include additional measures of clinical and operational performance.

The replacement of the existing computer-aided dispatch system later this year will put WAST in a much stronger position to manage all calls more effectively through the better identification and allocation of the most appropriate resource. The new system will be supported by a £4.5 million of Welsh Government investment and is expected to be online later this year.

Our pilot has attracted global interest. The Welsh ambulance service have been invited to provide advice to a number of international ambulance services, including Canada, New Zealand, Australia, USA, Chile and England. In fact, the Scottish Ambulance Services NHS trust is currently piloting a very similar model, directly referring to the work undertaken here in Wales. There is a significant opportunity here to build upon the success of the model to date to further evidence this successful innovation and step forward.

I recognise that it takes time for new ways of working to become established. The clinical model has proven to be effective in enabling the Welsh ambulance service to prioritise a response to the greatest level of need. However, the model itself is not a panacea. There is a clear acknowledgement from the Welsh ambulance service and from EASC that there are opportunities to improve care for patients in the greatest need, and to ensure patients with less serious need continue to receive a safe and timely response. I have, therefore, written to Professor Siobhan McClelland, directing EASC, to develop a way forward in response to the evaluation report’s recommendations to support the work that is already under way to deliver high-quality ambulance services for the people of Wales.

The new model has proven to be a positive step forward. However, it has only been possible because of the commitment and skill of our staff who deliver the ambulance service, and I am truly grateful to them, both in making the case for change and in then delivering that change. I will of course continue to monitor performance and the implementation of the new model.