The Welsh Ambulance Service is still feeling the affects of the pandemic as pressure continues to increase in Emergency Departments.
Difficulties with discharging patients is resulting in patients facing long waits to be admitted, queues of ambulances piling up outside the departments and people in need of urgent medical care, facing longer waits for the arrival of ambulances.
Wrexham councillors have been given an insight into why the situation in the county is so bad currently.
Jason Killens, chief executive of the Welsh Ambulance Service addressed councillors in Wrexham Council's Safeguarding, Communities and Wellbeing Scrutiny Committee about the problems faced as a result of the Covid-19 pandemic.
In documents shown to the committee, the Betsi Cadwaladr Health Board lost 6,000 handover hours because of delays, almost double the nearest health board and just under 48% of urgent emergency calls had been responded to in the eight minute time frame, almost 20% below the Ambulance service target.
"We have impacts of the pandemic still playing out, the pandemic very much hasn't gone away," he said.
"We've got high levels of community prevalence of covid. Our people, our staff, our volunteers are the community, so with high community prevalence we have higher than usual sickness or absence rates. Double what we'd expect them to be."
Mr Killens added: "We've got more work than we've ever had before, essentially some of our days for 999 calls are 25-30% busier than we would expect for this time of the year.
"We've got pressure across urgent and emergency care, which means flow through the hospitals is impacted and that ultimately means delays in the emergency department, which translates into ambulance waits outside the emergency department, which translates to delays in the community in terms of our ability to respond.
"We have twice as much red activity (life threatening calls) than we had pre-pandemic. There are are certain factors that are associated with the pandemic, such as the need for our crews to wear full Personal protective equipment (PPE) when they respond to every red call, which is adding further stress to our ability to respond in a timely way.
"We did a time in motion study early in the pandemic to understand the affect on our ability to respond of the requirements around PPE and it adds between two and six minutes to the response of each of those red calls."
Mr Killens added: "The winter forecast this year, taking into account covid, flu and other respiratory viruses as well as adverse weather indicates we'll be busier than the winter of 2017/18 which is held as one of the most difficult winters.
"What we are currently seeing is calls to 111 and 999 services from patients in the community who have covid who need advice or assistance. So while the number of patients in hospital is less than previous waves, the community impact is very much there.
"With the waits at hospitals, they are significantly worse than they were pre-pandemic, essentially they have trebled since early 2019. This means we have less capacity available to respond to patients in the community because ambulances are waiting to hand over patients at the emergency departments.
"We then see regrettably long waits in the community, far too many patients waiting far too long. We recognise the service these patients are receiving falls below the standard we want to provide."
Mr Killens discussed the impact the army has had since getting involved over the last few weeks.
"The short term answer is more capacity on the streets. The military have been back for the third time through the pandemic and are assisting us currently.
"Those additional people that have joined us from the military in the last three weeks, means we have 4,000 additional ambulance hours a week available to respond to patients, roughly 10% more ambulances on the street than we had before they joined us.
"If I compare the last three weeks since the military have been back, with the previous three weeks, we've had more work in the last three weeks than we did in the three weeks before but because of the additional capacity, we've taken 90 minutes off the tail of our response time.
"In the amber category of calls, we've had the best medium response times since August as a result of the additional capacity. It is making a difference."
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