The original inquiry report, published in December 2006, concluded that the ambulance service had longstanding and severe problems; but also that it possessed strengths which should, over time, help achieve improvements to its services. The Auditor General made 28 recommendations to be implemented by the service.

The Wales Audit Office follow-up work contributed to a wider project undertaken by a Review Group set up by Edwina Hart, the Welsh Assembly Government’s Minister for Health and Social Services. It was led by Stuart Fletcher, the Chairman of the Trust, and considered the implementation of the Auditor General’s recommendations and the robustness of the Trust’s five year modernisation plan, Time to Make a Difference.

The Wales Audit Office found widespread improvements, but some difficult problems remain. There have been general improvements in response time performance. While most patients receive an ambulance to back-up the Trust’s initial response, a minority of people still wait far too long for ambulance back-up and regional variations remain across Wales. There has been significant investment in new fleet and clinical equipment and progress in leadership and governance within the Trust.

Auditor General for Wales, Jeremy Colman, said today: “There have been widespread improvements within the Trust through the implementation of the majority of my initial recommendations and actions in the Trust’s modernisation plan.  eighteen months into a five year programme of major change, some aspects of performance remain far from satisfactory .”

The problems centre on staff morale, management capacity, excessive turnaround times for ambulance crews at hospitals, and the effectiveness with which the Trust matches supply and demand. The Wales Audit Office report also points to a range of financial risks and the importance of effective work with partners to make the whole system of unscheduled care function more effectively.

The Auditor General adds “I welcome the Chairman’s report and was pleased to contribute to it. Essentially, the ambulance service is doing better, but feeling worse. It is encouraging to find improvements in the service, but it is vital to recognise that it will take more time to turn the Trust around. It is now essential that the Trust takes a robust approach to addressing the key challenges it faces, not least improving the morale of its workforce and their engagement in the modernisation process. Action on the sixteen additional recommendations I have jointly made with the Review Group will be an important part of this process.’

Notes to Editors:

• In July 2006, following public concern about the Welsh Ambulance Services NHS Trust, the National Assembly invited the Auditor General, Jeremy Colman, to lead an inquiry into ambulance services in Wales.
• The 2006 inquiry sought to confirm the nature and extent of the perceived problems with the ambulance service.  The inquiry also focused strongly on the future and the plans being developed by the new Chief Executive to improve ambulance services for the people of Wales. The inquiry report was published in December 2006 and drew on joint work with Healthcare Inspectorate Wales, who undertook a review of clinical governance, patient care services and specific investigative work to assess the claim that the way in which the service operated caused the avoidable loss of 500 lives.In December 2007, the Minister for Health and Social Services invited the Trust’s Chairman, Stuart Fletcher, to carry out a further review to assess:

progress against these recommendations;

the robustness of the trust’s five-year modernisation plan;

progress against the actions set out in the modernisation plan; and

the effectiveness of infection control and cleanliness in ambulance vehicles.

• The Wales Audit Office contributed to the Chairman’s review by assessing how well placed the Trust was to deliver the improvements required by the Auditor General’s inquiry report and the Trust’s own modernisation plan, Time to Make a Difference. The Review Group was also supported by David Galligan of UNISON and Professor Morton Warner, an independent academic expert in health service management.
• The Welsh Ambulance Services NHS Trust was set up in 1998 through the merger of five predecessor ambulance services. The Trust employs nearly 2,500 staff and had an annual turnover of £111 million in 2006-2007.
• The Wales Audit Office is independent of government and is responsible for the annual audit of some £19 billion of annual public expenditure. Its mission is to promote improvement, so that people in Wales benefit from accountable, well-managed public services that offer the best possible value for money. It is also committed to identify and spreading good practice across the Welsh public sector.
• The Wales Audit Office was created in April 2005 through the Public Audit (Wales) Act, 2004, which expanded the functions of the Auditor General for Wales and enabled the transfer of staffs from the Audit Commission in Wales and National Audit Office in Wales to his employment.
• For more information please contact Helen Keatley on 02920 320518 or email helen.keatley@wao.gov.uk