5. What is the Government doing to limit the time that ambulances are forced to wait in queues outside hospitals? OQ59276

Llywydd, we've provided additional funding, established a national improvement programme and increased staffing in the Welsh Ambulance Services NHS Trust. Where health boards take concerted, whole-system action, clear results are already being seen in reducing ambulance waiting times outside hospitals.

Thank you for that.

After waiting for an ambulance for hours, when people get to hospital, there are often no spare beds, leaving them waiting outside for more hours. One constituent of mine's elderly mother was recently held in an ambulance for 15 hours after she suffered a fall. I am concerned that ambulances are effectively being used as waiting rooms. I want to ask you specifically, though, about the impact that so many ambulances waiting with their engines running is having on air pollution levels outside our hospitals, areas where people are already desperately poorly and are now breathing in polluted air.

Last month, I know the health Minister announced that there would be charging points outside each emergency department. BMA Cymru have welcomed that scheme, but there isn't much detail yet about where the funding will come from and when, and also on upgrading ambulances to electric vehicles. Could you give more detail on that, please, and could you also say how the Government will monitor air quality outside hospitals in the meantime, because if ambulances are being used as waiting rooms, we shouldn't be keeping patients waiting in environments that will make them more unwell?

Well, Llywydd, the fundamental answer is not to have ambulances waiting in that way, and while the position in the health service continues to be very challenging, there is some good news in this area. By taking the whole-system approach to which I referred in my original answer, Cardiff and Vale University Health Board, working with the ambulance service, achieved a 50 per cent reduction in the number of ambulance hours lost to handover at the University Hospital of Wales between January of this year and January of last year. And the lessons that are there to learn from that successful experiment are now being spread to other parts of Wales. So, Delyth Jewell will be, I know, interested in what happens in south-east Wales and, since the start of this month, a new safe-flow model has been in place at the Grange University Hospital, drawing very much on the work that has proved successful at UHW.

The way to improve air quality is not to have ambulances waiting to the extent that they have been. Where they do have to wait, they should be electric vehicles, not petrol vehicles, and that's why the Minister announced that we will be improving the infrastructure at the hospital front door, so that it is easier for ambulances to operate in that way. There is already very significant investment by the Welsh Government in improving the Welsh ambulance service fleet in that way. The money for the charging points will come from the Minister's own budget, and she has identified that, and I'm sure that there will be further information that she will be able to share with Members as that plan develops.

I notice that England and Wales had very similar ambulance response times to the most serious emergencies in January. But I noted that ambulances in England are 20 minutes faster at reaching their category 2 patients than those in Wales are at reaching amber patient calls. I listened to your answer to Delyth Jewell, and it's quite right to learn lessons from certain part of Wales where there is good experience and replicate that in other parts of Wales, looking for where best practice is. But I wonder what best practice the Welsh Government is planning to lift from NHS England to reach those patients faster, particularly in relation to the delayed transfers of care, of course.

My starting point, Llywydd, is always that where there are lessons to be learnt, inside or outside Wales, then of course we would want to learn them. From my long experience of these sorts of discussions—and I don't have this in front of me—what I would suspect would be that there will be different definitions of what is captured by a category 2 response, so we're counting different things, and of course we're counting them on a different geography as well, because a higher a proportion of Wales will be classified as rural areas, with the challenges that come, compared to across the border.

But I can assure the Member that the people who work in our ambulance services are always in contact with people who run ambulance services in England, partly because it is a porous border. The Minister herself is committed to doing that, and the learning is in both directions. We were the first part of the United Kingdom to agree on the current way in which ambulance service performance is measured. That was then subsequently adopted in England. And that's because there is a dialogue, always, between professional workers and officials hoping to see where there are things that can be learnt from one another.