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Changes to how the Welsh Ambulance Service responds to serious health issues like strokes and heart attacks are being introduced.
A new ‘orange: time sensitive’ category is being introduced to prioritise fast assessment, response, clinical care, transport, and reaching specialist care.
Currently, people suffering a stroke or STEMI, a type of heart attack, are grouped with many other cases in the broad “amber” category, which represents 70% of all 999 calls to the ambulance service.
What are the new categories?
The changes replace the current categories with:
- Orange: time sensitive – for conditions needing a fast response and care from ambulance clinicians before transport to hospital for specialist care, such as a stroke.
- Yellow: assess and respond – for conditions which require further clinical assessment to determine the best pathway of care, such as a person suffering from abdominal pain who may be suitable to stay at home or may need further investigations.
- Green: planned response – for conditions such as a blocked catheter which may require community care or planned transport to urgent care services.
The new categories, which replace the current amber category, are scheduled to be implemented before the winter as part of a new emergency ambulance performance framework.
Source: Welsh Government
Wales’ health secretary, Jeremy Miles, said: “For people in stroke, every minute counts if lives are to be saved and disability reduced or prevented – with each minute that passes, around two million brain cells are lost.

“That’s why we’re introducing a new orange category into the system which will help our ambulance service identify time sensitive complaints, such as stroke, quickly – and get patients the right specialist treatment faster.
“This will help ensure that people experiencing a stroke receive the rapid, tailored response they need to survive, recover and thrive following a stroke.”
A pre-hospital video triage approach is being trialled at five Welsh stroke units, with support from the ambulance service, in a bid to help patients with time-sensitive complaints, such as strokes, to receive timely treatment.
Andy Swinburn, Executive director of paramedicine at the Welsh Ambulance Service, welcomed the changes. He said: “The nature of how patients present to 999 has changed and it’s important to reflect this in the way we respond, first and foremost to increase ambulance availability for those who truly need it – but also to ensure that patients who can be cared for closer to home get that opportunity.
“This latest change, which builds upon those already introduced for the most life-threatening calls, is another step towards creating the framework to do this.”
Dr Shakeel Ahmad, national clinical lead for stroke in Wales, said: “When a patient is having a stroke, urgent rapid treatment is critical as every second counts in order to restore blood flow to the brain for those patients eligible for treatments to remove or disperse blood clots from the brain.
“The new ‘orange: time sensitive’ category will be able to prioritise stroke patients who require this urgent treatment.
“The category changes are important steps towards a transformed model for stroke care in Wales. This will enhance the stroke pathway leading to greater number of patients receiving life changing treatment in a timely fashion.”
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