Thank you for the series of questions and comments. I’ll start with some of your points about clinicians in other parts of the health service and the point about delays in treatment, or otherwise. There is, of course, a challenge about seeing the ambulance service as part of the whole system, and not just that whole patient—[Inaudible.]—partly about the ambulance service. And that’s why we do have a real focus on hospital delays, regularly publishing information about delays in individual sites and in health boards. It’s why it’s part of the accountability that takes place with health boards about their whole population responsibility.

There’s also something about making sure—and the report also highlights this as well—there are alternative places for people to go for their treatment, because, sometimes, somebody will need treatment, but it won’t be in a hospital. So, it’s about referring them on to a different setting, that’s in the community, or in another part of the whole healthcare system. That absolutely is part of what we are looking at, as a whole system. And that also is informed by one of the recommendations in the review.

On your point about staff training, both the internal training, within the service, so that the staff are appropriately equipped and skilled, but also on the future workforce, and my recent announcement of the £95 million we’re investing in the NHS workforce of the future—the numbers of paramedics we’re training for the future, we think they’re in line with what we need, but we do think that there is a need for a different skill mix, in how people will be deployed. So, that actually is part of what we’re doing. There are a range of different models, looking forward. For example, on my recent series of visits to see paramedics at their stations, I’ve met with a number of people undertaking some of those pilots. In the Vale of Glamorgan, I met with a paramedic who was undertaking a community pilot. I also met with advance practitioners undertaking a similar pilot in Aberdare, with the Member for the Cynon Valley. So, they’re looking at different models to evaluate and understand where the place is then to make the biggest and best impact on improving patient outcomes. So, that work is already being undertaken and that will help to enforce the sort of workforce we need for the future.

On your broader point about patient outcomes—and then I’ll come back to your point about the amber category—we’re, of course, interested in the whole patient journey, so looking at outcomes isn’t just about what the ambulance service do. That’s why linking data through different parts of the health service is really important. So, the investment that we’ve made in digipens, for example, means that it’s much easier to transfer those data on. We will have an opportunity, because of the way we organise this, to look at someone’s journey through the whole system and to understand how interventions, both in the ambulance service and on the five steps we’ve set out for them, but also the rest of our healthcare system, which interventions are having an impact on that ultimate patient outcome? The Picker Institute work is telling us about patient experience, because often the complaints that are made about the health service are about the experience people have in that healthcare, as opposed to the ultimate clinical outcome. So, that linking of data is hugely important.

Now, on your point about stroke and the amber category, I go back to the fact that the review that we’ve had that actually recommended the pilot that we’ve just had an evaluation undertaken on has been based on clinical evidence about the right thing to do. I don’t recognize your assertion that there are 10 per cent of life-threatening calls made to the ambulance service rather than the 5 per cent that are categorised by the red category. We acted on the very best available clinical evidence and advice in undertaking the new pilot, and are moving forward with the new model. The review that’s been undertaken following the evaluation is to look at whether we have got appropriate boundaries drawn between red and amber and amber and green for the different categorisation that exists. So, I will continue to be guided by the clinical evidence and advice from that review about whether each condition is in the right category. I recognise that Welsh Conservatives say they want particular conditions moved, but, frankly, if it’s just the view of Welsh Conservative politicians that they want conditions moved around, that won’t persuade me. What would persuade me that there is a change needed is if there is real clinical evidence and advice that this is the right way to use precious ambulance resources to improve outcomes for patients, and that work is being carried out following the direction I’ve given to the chair of the emergency ambulance services committee.

I look forward, on stroke performance, and in dealing with your other point Angela Burns—in the near future, I’ll be making a statement in this Chamber on stroke performance across the whole pathway, on the way in which we objectively and overtly measure stroke performance within the system. I think, actually, that we’ve got a good story to tell in Wales about improving performance in stroke, and I look forward to making further progress in the future.