What will the EMRTS Service Review do?
The EMRTS Service Review will ensure an impartial and objective scrutiny process that will be independent of the assumptions, comparisons and modelling included within the original proposal. The Review will:
describe how the current service is provided
explore and maximise existing bases and options to reconfigure
ensure that resources are available when patients require them and minimise occasions where resources not available
ensure a broad data reference period and that weather and seasonal variation are taken into account in the modelling
allow stakeholders to consider how we measure the benefits and risks of each option
clearly present the options and their benefits, risks and impact using the modelling undertaken and the agreed investment objectives and weightings
include the current service as an option so that new options can be compared to this.
The EASC Team will prepare an EMRTS Service Review Final Report, this will:
describe the process that has been undertaken
present the key themes from/summarise the information received from stakeholders (feedback, views, concerns)
clearly present the options (including their benefits, risks, and the main impacts) using the modelling undertaken and the agreed investment objectives and weightings, supported by the feedback received from stakeholders
make a recommendation to the EASC Committee, Members will make a final decision informed by the information presented to them.
What is the formal public engagement process and what will it do?
Community Health Councils (CHCs) in Wales are required to reflect the views and represent the interests of people in their NHS. NHS organisations are required to work with the CHCs, and it is for the CHCs to decide on whether an engagement or consultation process is required when there is a proposal to develop or change the way NHS services are provided.
The CHCs have confirmed that an eight-week formal public engagement process should be undertaken in relation to this work, this will include a review after six weeks. The process will ensure that the views of stakeholders are considered in the decision-making process and to ensure that the key issues are understood.
Who can participate in the EMRTS Service Review engagement process organised by EASC?
The process is open to anyone in Wales. Any member of the public, staff, and organisations – including Wales Air Ambulance and EMRTS - can provide feedback throughout the engagement period so that key issues are understood to inform the decision making process.
Who will you engage with during this process?
We are updating a list of key stakeholders, and anyone can be included by providing information on the EASC website https://easc.nhs.wales/commissioning/emrts/sdp/.
What is modelling?
In health service planning, modelling techniques can be used to forecast the effects of changes on access to services and to calculate the required capacity of services, given assumptions about patterns of demand and levels of utilisation.
Why is modelling needed for this process?
Modelling will ensure that EMRTS activity data, weather probability information and seasonal differences are used to project the potential future state that can be delivered.
The modelling will provide key information including utilisation and the numbers of patients seen for each option. Modelling will act as one element of this decision-making process. The benefits, risks and impact of each option will be clearly presented within the EMRTS Service Review Final Report. This information will inform the recommendation that is made to the EASC Committee.
Who does the modelling for this engagement?
An external company with expertise in predicting and modelling emergency services is used. This is in line with other services commissioned by EASC. We are using CSAM Optima, a world leading company who are very experienced in this type of work.
Who is responsible for making the decision about any service developments?
The Emergency Ambulance Services Committee is responsible for commissioning the EMRTS and will decide if any developments need to happen based on evidence and following appropriate engagement with key stakeholders including health boards, the Wales Air Ambulance Charity, EMRTS staff and the public.
Will all data be made available?
Data will be made available in accordance with General Data Protection Regulation (GDPR) and Data Protection Act 2018. As much data as possible will be shared during the engagement process, whilst always meeting the data protection principles as legally required. In terms of the data underpinning the work – we will not be in a position to provide the source data as this is EMRTS missions, patient-level data which could lead to individuals being recognised. This is because an individual incident would be identified along with the date and location.
A lot of the data is classed as personal data as defined under the General Data Protection Regulation (GDPR) and Data Protection Act 2018 and its disclosure would be contrary to the data protection principles and constitute as unfair and unlawful processing in regard to Articles 5, 6, and 9 of GDPR. We would therefore withhold this detail under Section 40(2) of the Freedom of Information Act 2000 (FOIA). This exemption is absolute and therefore there is no requirement to apply the public interest (as part of the FOIA). Where we are able to share data, for small numbers we use “less than 5” to protect the disclosure of individual information.
A significant amount of data used to develop the EMRTS Service Development Proposal is available in the original service development proposal document https://easc.nhs.wales/the-committee/current-and-past-papers/november-2022/231-emrts-service-development-proposal/.
When is the engagement process happening?
The formal engagement period will start shortly, as it stands/what we have previously said is
Part 1 will:
Describe how EMRTS works now
Discuss what must be in place and what are the must haves (constraints)
Discuss how we measure the benefits and risks of each option (investment objectives)
Discuss how the process reflects that some benefits are most important than others (weightings)
Review after six weeks to consider the process to date; discussions, agree the constraints, investment objectives and weightings to inform further areas for modelling.
Part 2 will:
Present options including benefits and risks.
Who is co-ordinating the engagement process?
EASC, as the commissioner of services, is planning and co-ordinating the engagement process and its team, led by the Chief Ambulance Services Commissioner will lead the work in an impartial way, independent from both Wales Air Ambulance Charity and EMRTS. CASC will present the evidence and information for consideration by EASC who will make the final decision.
How transparent will the engagement process be?
The engagement process will be transparent with all details, information, and materials available on the EASC website.
How can feedback be provided in the formal engagement process?
Feedback can be provided by:
In-person meetings
Virtual meetings/sessions
Online survey
Hard copy
Telephone
What will the formal engagement process cover?
Describe how EMRTS works now
Agree the ‘rules’ for comparing different options
Present the benefits, risks, and impact of each option.
Who has agreed the engagement materials? Who has been involved in setting up the process?
The EASC Team has worked with communication, engagement, and service change leads in health boards and with CHC (Community Health Council) representatives to ensure the required public perspective. This work has included agreeing the approach for the formal public engagement process, agreeing engagement materials, and agreeing the timelines. This work will continue in order to coordinate local arrangements and ensure there is appropriate opportunity for those that wish to participate to do so.
Will the engagement be available in English and Welsh?
Yes.
How will feedback be collated, assessed, and analysed?
All feedback will be collated, assessed, and analysed by an external specialist supplier arranged by EASC.
What will be done with the information and questions that you receive?
The information already received to date from stakeholders via the online contact/feedback form on the EASC website (https://easc.nhs.wales/commissioning/emrts/sdp/) and via in-person and virtual meetings as part of the continuous engagement process will be considered as part of the EMRTS Service Review. In addition, feedback received as part of the formal public engagement process will be fully considered.
The final report will describe the process that has been undertaken and will clearly present the options (including their benefits, risks, and the main impacts) using the modelling undertaken and the agreed investment objectives and weightings, supported by the feedback received from stakeholders.
Will I be able to comment on the options after they have been presented?
Once the options have been modelled, these will be presented as part of the formal public engagement process.
The benefits, risks and impacts of each option that has been modelled will be presented to stakeholders as part of the formal public engagement process. Stakeholders will be able to provide feedback on this.
How and when will a final decision about developments be made?
The feedback received will be collated and will inform the final report. The EASC Committee will receive the report and the recommendation within and make a formal decision. The date of this meeting is not yet decided as the formal engagement process will need to be completed first. EASC meet every other month and where required can hold a special meeting if members agree. Therefore, the decision meeting can be planned in advance and the date will be shared as part of the engagement process.
Is the engagement process just a formality and has the decision about future airbase locations already been decided?
No. Feedback received as part of the formal public engagement process will be fully considered alongside the data modelled and will inform the recommendation to EASC for decision by EASC Committee Members.