Cross-border healthcare – overseas patients

16 March 2017

Article by Philippa Watkins, National Assembly for Wales Research Service

Darllenwch yr erthygl yma yn Gymraeg | View this post in Welsh

Image of a health professional holding a clipboard The UK Government recently announced that NHS hospitals in England will be required to charge patients from overseas upfront for non-urgent, planned care unless they are eligible for free treatment.

How does this apply to the devolved administrations? What are the arrangements for non-UK residents to access NHS healthcare, and for Welsh (and UK) patients to receive treatment abroad? Is this likely to change following the UK’s withdrawal from the EU?

Access to NHS services in the UK – ordinary residence

Entitlement to free NHS healthcare is based on being ‘ordinarily-resident’ in the UK. Ordinary residence is not dependent on nationality, paying UK taxes/national insurance, having an NHS number or being registered with a GP, or owning property in the UK. It has become accepted to mean that a person is living here lawfully, voluntarily, and for settled purposes. Under the Immigration Act 2014, a person must have indefinite leave to remain in the UK in order to be regarded as ordinarily resident.

Across the UK, some types of healthcare, including GP services and treatment in an accident and emergency department, are currently free to all patients whether they are ordinarily resident or not. For non-UK residents, most hospital treatment is subject to charge, although some groups of people are exempt, for example refugees, asylum seekers and looked after children. Additionally, patients who have rights to healthcare under EU legislation or other reciprocal healthcare agreements may also be exempt from charges. More detail about these arrangements – which also apply to UK residents receiving treatment abroad – is provided below.

As of April 2015, non-EEA nationals coming to the UK for longer than six months may be liable to pay an immigration health surcharge as part of their visa application. This entitles them to NHS treatment on the same basis as permanent UK residents.

Charging regulations

NHS organisations across the UK are required by regulations to establish whether someone is liable to pay for NHS services and to charge them accordingly.

The UK Department of Health has said that the new requirement for hospitals to charge overseas patients upfront will come into effect in April 2017. This applies to England only – separate regulations govern the charging arrangements in the devolved administrations. In Wales, the Welsh Government is reviewing the existing charging regulations and guidance, and is expected to publish updated versions in draft form for consultation in spring 2017.

Residents of EEA countries (including UK residents)

Unplanned treatment

Residents of European Economic Area (EEA) countries and Switzerland can apply for a European Health Insurance Card (EHIC), which will allow them to access state-provided healthcare during a temporary stay in another EEA country/Switzerland. The EHIC covers any necessary medical treatment that cannot be postponed until you’ve returned home. This includes treatment for chronic or pre-existing medical conditions and also routine maternity care (this includes unplanned childbirth, but would not provide cover for someone planning to give birth abroad).

Treatment should be provided on the same basis as it would to a resident of that country. In many cases this will be free, however in some countries patients are expected to contribute towards the cost of their state-provided treatment, and this will also apply to EHIC holders receiving treatment in those countries.

It’s emphasised that the EHIC is not an alternative to travel insurance – it will not, for example, cover someone for rescue and repatriation following an accident.

Planned treatment

There are two potential routes under which EEA residents can travel to another EEA country for planned healthcare:

  • the EU Directive route;
  • the S2 scheme.

Under the EU Directive on patients’ rights in cross-border healthcare, patients are able to purchase state or private healthcare in another EEA country and seek reimbursement from their home country (up to the cost of that treatment at home). The EU Directive route does not apply to Switzerland.

Prior authorisation is not necessarily needed, although this will be a requirement for some types of healthcare, generally inpatient care and highly-specialised, cost-intensive treatment. Under the Directive, patients are not able to obtain reimbursement for treatment that they would not be entitled to at home.

Further information about arrangements under the EU Directive can be found in the Welsh Government’s guidance for the NHS on cross-border healthcare and patient mobility.

Under the S2 route, EEA and Swiss residents are able to seek planned treatment in other EEA countries/Switzerland, but must obtain prior authorisation from their own Member State, which bears the cost. The S2 route applies only to state-provided (not private) treatment.

The S2 form acts as a form of payment guarantee – in the majority of cases, the patient is not required to pay anything themselves (other than any relevant statutory charges that would also apply to those ordinarily resident, for example prescription and dental charges in the UK).

Pensioners living abroad

Under the S1 scheme, pensioners settling in another EEA country or Switzerland are able to access healthcare services in that country on the same terms as ordinary residents. The S1 form is issued by the country that pays your pension, and must be registered in the country in which you now live.

The S1 scheme is mostly used for pensioners but may also apply to other groups such as posted workers and cross-border workers.

The UK Government acts on behalf of the UK as a whole to reclaim costs from other EEA member states under the S1, S2 and EHIC schemes.

Impact of Brexit

The UK is a net ‘exporter’ under the EU’s reciprocal healthcare arrangements, paying out more to other EEA countries than it receives. This is largely due to the greater number of UK pensioners living abroad. In February 2017, the UK Department of Health told the House of C0mmons’ Health Committee:

on an annual basis, we pay out roughly £650 million a year to cover the costs of UK‑insured pensioners in other EEA countries and UK visitors to those countries.

(…)

Of that, about £500 million is on pensioners, so that is UK‑insured pensioners, of which there are about 190,000 in other EEA countries. I think the figures there are 70,000 in Spain, 44,000 in Ireland, 43,000 in France and about 12,000 in Cyprus. Those are the main countries.

The above arrangements remain in place while the UK is still a member of the EU, but it’s not yet clear how things might change following the UK’s withdrawal. In evidence to the Assembly’s External Affairs and Additional Legislation Committee, the Welsh NHS Confederation said:

If the UK were to leave the EU single market, these systems would in principle no longer apply in the future, unless bilateral agreements were negotiated. Consideration should be given by negotiators to possible implications for patients and how to ensure that a fair alternative system is put in place, either with the EU as a whole, or with those EU countries, such as Spain, which have high numbers of UK nationals living there.

Non-EEA countries

The UK has reciprocal healthcare agreements with a number of individual countries outside the EEA. These agreements may provide for immediately necessary treatment for conditions which arise, or existing conditions which become acutely worse, during a temporary visit. The level of care which may be provided free of charge varies. As with the EHIC, it’s recommended that those travelling in other countries take out adequate travel insurance to cover their stay abroad.

Some reciprocal agreements may also provide for a limited number of referrals specifically for the treatment of pre-existing conditions (this would normally only apply where the referring country does not have adequate facilities to provide the treatment needed).

Further information

  • National Contact Points in each EEA country can advise patients on their rights under the EU arrangements.
  • Information about accessing planned or unplanned treatment in another European country can be found on the EU’s Your Europe website.
  • Further information and advice for people visiting or moving abroad, and for those seeking treatment in Wales, is provided by NHS Direct Wales.

See our June 2016 briefing for information on the cross-border healthcare arrangements between Wales and England.

 

School Federation; the solution to the closure of rural schools?

15 March 2017

Article by Joseph Champion, National Assembly for Wales Research Service

Darllenwch yr erthygl yma yn Gymraeg | View this post in Welsh

a row of school desks

Image from Pixnio by Amanda Mills. Licensed under Creative Commons.

On 15 November 2016, the Cabinet Secretary for Education, Kirsty Williams, announced her intention to make changes to the School Organisation Code. The primary objective of the changes will be to introduce ‘a presumption against the closure of rural schools’, something which is already in place in Scotland and England.

This presumption can be traced back to one of the education priorities Kirsty Williams, set out to First Minister, Carwyn Jones before joining the Welsh Government. One of the reasons why such a presumption has not been in place in Wales is that there is no official definition of a ‘rural school’ in Wales, which is another thing the Cabinet Secretary wishes to change in the School Organisation Code.

This proposed presumption would mean that

  • Cases to close rural schools must be strong; and that
  • Local authorities [will have] to carry out more rigorous consultation and conscientiously consider all viable alternatives to closure including linking up with other schools, known as federation.

As well as changes to the School Organisation Code, the Cabinet Secretary also committed to making an extra £2.5 million available to the, soon to be defined, rural and small schools from April 2017. This extra funding will be ‘to support schools working together’ and for the

development of federations across all maintained schools and better information and guidance for those considering collaboration and federation.

This might signal a change in direction for Welsh Government policy, which in the past has focused on reducing the number of surplus spaces in schools in Wales. This often meant closing schools which were deemed to have insufficient pupils. As a result of a Written Assembly Question (WAQ) from Conservative Assembly Member, Darren Millar in July 2016, it emerged that the majority of these closures were in ‘rural Wales’.

What is school federation?

Schools in Wales have been able to federate since 2010 and the introduction of the Federation of Maintained Schools and Miscellaneous Amendments (Wales) Regulations 2010. The rules regarding federation were updated through the passing of The Federation of Maintained Schools (Wales) Regulations 2014. The first schools to federate were Michaelston Community College and Glyn Derw High School in Cardiff in 2011.

The Welsh Government’s guidance on federation provides an overview of the term:

The term federation describes a formal and legal agreement by which a number of schools (between two and six) share governance arrangements and have a single governing body. Federations can involve a mix of maintained community and community special schools which are either nursery, primary or secondary schools.

However, under the new 2014 Federation Regulations schools with a faith and/or a trust such as voluntary aided, and voluntary controlled can only federate with schools of the same category or with schools that have a similar charitable trust status and/or religious ethos. Foundation schools will only be able to federate with other foundation schools.

The guidance also notes that there is

no blueprint for federation and the design or operational workings of a federation will depend entirely on the circumstances of the individual schools and the focus or purpose of their wanting to work together.

However, the most important reason for considering federation must be the benefits such an arrangement would bring for children and young people through enhanced educational provision.

Why federation?

A report published by the National College for Teaching and Leadership, entitled ‘A study of the impact of school federation on student outcomes’, indicated that school federation:

  • has a positive impact on student outcomes, although the effect can take two to four years to become apparent;
  • offers greater resources and consequently opportunities for change and the provision of additional services; and
  • provides more opportunities for professional development for staff, often at reduced cost, across the federation, and at times beyond the federation. A federal structure also promotes opportunities for collaboration between schools, which is seen as important in raising standards in Wales.

While all of the above are relevant and desirable outcomes in Wales, there is a further driver for federation, namely the number of surplus places in Welsh schools.

Surplus school places in Wales

The push to reduce surplus places in schools was supported by the previous Welsh Government, which recommended that local authorities have no more than 10% surplus places across all primary and secondary schools in its area. At an individual school level, a significant level of surplus provision is defined as 25% and at least 30 unfilled places.

It supported this push with its 21st Century Schools Programme and its School Organisation Code. The Code noted that it was ‘important that funding for education is cost effective’. The Code also stated that any reorganisation or closure would have to be ‘in the best interests of educational provision in the area.’

In 2012, Estyn published a report entitled How do surplus places affect the resources available for expenditure on improving outcomes for pupils? That report found that

closing a primary school will yield potential savings of £63,500 plus £260 for each surplus place removed. Closing a secondary school will yield potential savings of £113,000 plus £510 for each surplus place removed. [my emphasis]

This combination of factors have been perceived to have contributed to the closure of 157 schools between 2006/7 and 2015/16, primarily, it seems in rural Wales. Despite the closures, the Welsh Local Government Association, in a briefing to its Coordinating Committee, notes that by 2015

There were 19.6% surplus places in the secondary sector and 14.4% in the primary sector, a reduction of 3.2% in the primary sector since 2013. Over 40% of the surplus places in schools were in small schools, which are largely located in rural areas. [my emphasis]

It now seems that the new Welsh Government is going to adapt its approach to surplus places, although we are still waiting for the detail that will underpin this change. Perhaps this detail will emerge with the publication of the, yet to be published, strategy and implementation plan for federation and collaboration in Wales.

How should the National Infrastructure Commission for Wales work?

14 March 2017

Article by Gareth Thomas, National Assembly for Wales Research Service

Darllenwch yr erthygl yma yn Gymraeg | View this post in Welsh

On 15 March the Assembly will debate the Economy, Infrastructure and Skills Committee’s report on the National Infrastructure Commission for Wales (NICfW).  The Committee found much to agree with when scrutinising the Welsh Government’s proposals, but made 10 recommendations to help ensure that Wales’s current and future infrastructure needs are met.

What is the National Infrastructure Commission for Wales, and why did the Committee choose to look at it?

Construction of Pont y Werin, Cardiff

Image from Flickr by Ben Salter. Licensed under Creative Commons.

The compact between Welsh Labour and Plaid Cymru in May 2016 included a commitment to establish a National Infrastructure Commission in Wales.  The Welsh Government’s proposals for the NICfW are that it will be a non-statutory body that provides independent and expert technical and strategic advice to the Welsh Government on Wales’ long-term infrastructure needs over a 5-30 year period.  This will involve making regular reports to the Welsh Government on economic and environmental infrastructure.  Decision making and infrastructure policy will remain the responsibility of the Welsh Government.

The Cabinet Secretary for Economy and Infrastructure has said that his ambitions for the NICfW are to depoliticise contentious infrastructure decisions, and to speed up delivery of key projects.  While in October 2016 the Cabinet Secretary said that he would aim to set the NICfW up by summer 2017, in a written statement on 8 March he said that he now aims for it to be established by the end of 2017.

Scrutiny of the plans to establish NICfW was a key priority of a number of stakeholders who responded to the Committee’s consultation on its priorities held last summer.  Some of the main issues raised by stakeholders included the need for a long-term vision for infrastructure, the role and remit of the NICfW, how it will impact on key projects, learning from international best practice and how it can improve current arrangements for delivering infrastructure.

How did the Committee’s work add to the Welsh Government’s proposals?

The Welsh Government accepted 6 of the Committee’s recommendations, accepted 3 in principle and rejected 1 recommendation.  So the Committee has influenced the model for the NICfW in the following ways:

  • The preferred candidate for Chair of the NICfW will be scrutinised by an Assembly Committee in a pre-appointment hearing, as was recently done by the Finance Committee for the preferred Chair of the Welsh Revenue Authority.
  • The NICfW will produce a ‘State of the Nation’ report on future Welsh infrastructure needs every three years to detach its work from the political cycle, and will produce an annual report focussing on governance, past and upcoming work. The Welsh Government will respond to all recommendations within 6 months.
  • Its annual remit letter will provide information on how much the Welsh Government expects to be able to spend on infrastructure funding over the longest possible timescale, to give important context to its recommendations.
  • The remit letter will also encourage NICfW to build strong relationships with the UK National Infrastructure Commission and Scottish Futures Trust to maximise effectiveness.
  • Appointments to the NICfW will need to take account of the diversity of communities across Wales, and engagement at regional levels will be set out in its terms of reference.
  • The Welsh Government will explore mechanisms such as the Development Bank to focus on how more private funding can be used to support infrastructure developments.

And what’s still up for debate?

One of the Committee’s key recommendations was that, following its initial establishment, legislation would follow to make the NICfW a statutory body. 

This was influenced by evidence from federal and state level infrastructure advisory bodies in Australia which told the Committee that their status as an authoritative voice on infrastructure had been enhanced by their independent statutory status, and that the benefits of this approach would apply more widely than Australia.

The Chief Executive of the UK National Infrastructure Commission told the Committee that although being a non-statutory body had allowed it to be established more     quickly, there was also a downside since stakeholders perceive it to be less permanent.

The Welsh Government rejected this recommendation, as it does not consider that the role or remit of the NICfW would be enhanced by being on a statutory footing.  However it will consider this as part of a formal review taking place before the end of the Fifth Assembly.

There were also three recommendations which the Welsh Government accepted in principle.  The Committee recommended that the remit of NICfW be extended to include supply of land for strategically significant housing developments and related supporting infrastructure.  While the initial remit of the NICfW will remain as economic and environmental infrastructure, this will be reviewed by the end of the Fifth Assembly.

The Committee also wanted NICfW to be located outside Cardiff, and to share accommodation with another public body to lower costs.  The Welsh Government has said it will consider this, given the need for independence from a range of bodies NICfW will need to work with.

Finally, the Committee considered that NICfW should be considered a public body under the Wellbeing of Future Generations (Wales) Act 2015 to promote collaboration, engagement with the public and independence.  The Welsh Government will ensure that its terms of reference will make sure that NICfW is required to keep to the principles and goals of the Act.  However it will not seek to amend the Act at present.

The foundational economy

02 March 2017

Article by Jack Miller, National Assembly for Wales Research Service

Darllenwch yr erthygl yma yn Gymraeg | View this post in Welsh

Ceiling of the Senedd Chamber

As in the UK, Wales has lost much of its manufacturing base but retains its ‘foundational economy’, argue researchers from the Centre for Research on Socio-Cultural Change (CRESC). Whilst this ‘mundane’ yet vital area of the economy provides the goods and services essential for citizens’ well-being, they suggest it is ‘pervasively mismanaged’.

On 8 March, Assembly members will discuss the foundational economy during a Debate by Individual Members. This comes within the wider context of the development, by the Welsh Government, of a new economic strategy for Wales later this year. The Committee on the Economy, Infrastructure and Skills will hear from CRESC researcher, Professor Karel Williams, on 15 March to discuss the foundational economy during a session on alternative perspectives on what the strategy might include.

Foundational economy: The basics

The foundational economy is built from the activities which provide the essential goods and services for everyday life, regardless of the social status of consumers. These include, for example, infrastructures; utilities; food processing; retailing and distribution; and health, education and welfare.

They are generally provided by a mixture of the state (directly or through funding outsourced activities); small and medium enterprise (SME) firms; and much larger companies such as privatised utilities or branches of mobile companies such as the major supermarkets, who often originate from outside of Wales.

The importance of the foundational economy to Wales

Unlike manufacturing sectors where production is concentrated in specific areas, the foundational economy is nationally distributed along with population. As expressed by CRESC’s ‘Manifesto for the Foundational Economy’ (PDF, 435KB), in many areas of former heavy industry throughout Europe the foundational is ‘all that is left’. It is thus vital for many people in Wales, not only to provide the goods and services they need but also as an employer.

The report estimated that in 2013, 37.8 per cent of the Welsh workforce were employed in activities that contribute to the foundational economy, compared to 10.3 per cent in manufacturing. In England, 33.2 per cent of the workforce were employed in the foundational economy in the same year. A more recent report by CRESC researchers for the Federation of Small Businesses (FSB), entitled ‘What Wales Could Be’, suggests that ‘on any count, grounded SMEs and large scale foundational employers account for at least 40 per cent of the Welsh workforce’ (p.32).

Many sectors of the foundational economy are ‘sheltered’; because they are inherently local, international competition is limited and offshoring is difficult. Foundational goods and services are also ‘inelastic’, i.e. demand for these essentials does not change significantly when their prices or consumers’ incomes change. Combined, these effects lead to a greater level of resilience to external economic shocks in the foundational economy than, for example, in manufacturing, whose output can decline markedly during recession.

Challenges for the Welsh foundational economy

CRESC researchers have argued that the provision of foundational goods and services has been overlooked by industrial and economic policy in the UK and Wales, whose focus tends to be on high-tech processes and sectors. These are often technology-intensive, and produce tradeable and exportable goods, yet form a very small part of the Welsh and UK economies. Only three of the Welsh Government’s nine priority sectors for growth – construction, energy and environment and food and farming – produce foundational goods and services.

Moreover, they highlight that the foundational economy is marked by low-tech and low-wage employment, and that this issue is becoming more prevalent. Since 2010, they highlight that sectors such as hospitality and retailing – marked by low pay and part time work – have accounted for more than half the jobs created in the UK private sector.

There is a further issue of ‘occupational segregation’ in these sectors, whereby women are over-represented and hence often stuck in low wage or part-time work. This is a known contributor to the gender pay gap in Wales.

The FSB report highlights some of the specific issues facing foundational sectors in Wales. They suggest that in food, competitive chain supermarkets have captured the profits of food processors and left Welsh dairy and sheep farmers exposed to volatile market prices. In adult care, they continue, well-resourced private enterprises are displacing smaller family-run homes with large, purpose-built accommodation which can satisfy shareholder demand for high rates of return. This, they argue, has contributed towards an increasingly underpaid social care workforce, high local authority spending and worsening quality of care.

Towards a specific focus on the foundational

CRESC researchers call for a radical reframing of the economy that better accounts for the provision of foundational goods and services, considering ‘the multiple identities of citizens as producer, tax payers and consumers’ (p.70). The focus of this message involves moving beyond a key sectors approach to better understanding dynamics within sectors (for example, between firms of different sizes), as well as the behaviour of organisations within these sectors.

Given their significance both as providers and employers, by focusing on the quality of work within foundational sectors they argue that the Welsh Government could gain significant leverage on economic and social outcomes. Specifically, they suggest that the Welsh Government should ‘break with the idea of creating a generic business-friendly environment’, using non-standard policies which are adapted to sectoral characteristics and specific business requirements.

In food, for example, this might involve negotiating with suppliers on formal commitments on sourcing, training and living wages (p.70). Above all, the researchers argue that the Welsh Government should ‘encourage responsible business by promoting continuity of ownership for SMEs and “raising the social ask” of big business organisations in the foundational economy’ (p.7).

The Research Service acknowledges the parliamentary fellowship provided to Jack Miller by the University of Sussex, which enabled this blog post to be completed.

Getting there on time? Evaluating the Welsh Ambulance Services’ Clinical Response Model

24 February 2017

Article by Paul Worthington, National Assembly for Wales Research Service

Darllenwch yr erthygl yma yn Gymraeg | View this post in Welsh

Ambulance driving along a road

Background to the new clinical response model

Ambulance services in Wales have seen significant and recent change. In April 2013 the Strategic Review of Welsh Ambulance Services (the McClelland review) set out a number of recommendations for improving services, including proposals for new ways of monitoring performance on ambulance response times.

Following on from the McClelland review, from 1 October 2015 Wales Ambulance Services NHS Trust (WAST) implemented a new clinical response model for a 12 month pilot period, which was later extended for an additional 6 months. It was intended that during this trial, only the most serious calls, categorised as Red (immediately life-threatening), have had a response time target. All other calls would receive an appropriate response, either face-to-face or telephone assessment, based on clinical need. The new model has three categories of calls:

  • Red: Immediately life-threatening (someone is in imminent danger of death, such as a cardiac arrest). The target is for 65% of emergency responses to arrive within 8 minutes;
  • Amber: Serious but not immediately life-threatening (patients who need treatment delivered on the scene and may then need to be taken to hospital);
  • Green: Non urgent (can often be managed by other health services) and clinical telephone assessment.

The new clinical response model has also been supported by the development of a series of Ambulance Quality Indicators (AQI), which are published on a quarterly basis and contain a more detailed set of performance measures, including patient experience and clinical outcomes.

Performance against the new targets

The most recent statistics on ambulance response times published by the Welsh Government are for January 2017; Table 1 below shows the trends and Table 2 sets out the figures for January 2017 by Local Health Board area:

Table 1: Average red calls per day, and the percentage arriving at the scene within 8 minutes, Wales

chart8

Table 2: Emergency ambulance responses in Wales to red calls, January 2017

table-2

The performance data for January 2017 also shows that:

  • There were 39,864 emergency calls, an average of 1,286 per day, 4.3% down on the daily average for December 2016.
  • Of the total, 1,980 (5.0%) were red, 26,456 (66.4%) were amber and 11,428 (28.7%) were green.
  • 75.4% of emergency responses to red calls arrived within 8 minutes, above the target of 65%, but down from 75.8% in December 2016.
  • Performance ranged from 66.2% in Powys to 79.5% in Cardiff & Vale.

Ambulance services inquiries during the Fourth Assembly

In 2015 the Fourth Assembly’s Health and Social Care Committee undertook a short inquiry into the performance of Welsh ambulance services; later in the same year the Committee held additional sessions to examine what progress had been made in response to its original recommendations. This was shortly after the pilot of the new clinical response model had commenced.

As a result of the follow-up inquiries, the Committee wrote to Welsh Government welcoming the fact that the all-Wales target for emergency response times had been met for the first month of new trial model. However, the Committee was concerned that significant regional variations persisted and stated that it would like to see these addressed as a matter of priority and that it expected to see sustained progress in relation to response times at the local and national level.

In his response, the Deputy Minister for Health welcomed the Committee’s recognition of the progress achieved since the initial 2015 inquiry and stated that:

I am proud that we took a step forward for patients by implementing a clinical response model pilot intended to prioritise patients who need an immediate clinical intervention. The pilot is designed to enable ambulance clinicians and resources to be despatched appropriately based on clinical need.

The response also noted the progress made month-on-month against the targets and the publication in January 2016 of the first set of the new AQIs. The Deputy Minister also noted in further correspondence to the Committee that:

During the year-long clinical response model pilot, the AQIs will be published quarterly to allow a clearer understanding of trends and the impact of seasonal variation, sitting alongside the monthly publication of ‘Red’ response times. I can only re-iterate that the way we are sharing key information on ambulance services in Wales makes us the most transparent country in the UK and among the most transparent worldwide.

Review of the clinical response model

The Cabinet Secretary for Health, Wellbeing and Sport set out in a Ministerial Statement in September 2016 that the final evaluation report of the clinical response model was due in December 2016 and that he would make a final decision on the future of the pilot by the end of March 2017.

An interim report on the model received by the Emergency Ambulance Services Committee (EASC) in September 2016 had identified no significant areas of concern. The EASC has also received an update on the draft final evaluation report which indicates that:

…the removal of time based targets for the majority of calls has allowed for more efficient dispatching of ambulance resources, increased opportunities for hear and treat; and supported timely responses to patients with the greatest clinical need.

The EASC was due to have sight of the final evaluation report in January 2017, prior to its submission to the Cabinet Secretary for Health Wellbeing and Sport, who is due to make a statement regarding the evaluation to Plenary on 28 February 2017.

Image Source: Image from Flickr by Diluvienne. Licensed under Creative Commons.