The Welsh Ambulance Service is in need of a major overhaul, according to a Welsh Government review.
The review was commissioned by former Health Minister Lesley Griffiths last year after response targets were continually missed.
In March, figures show 53.3% of emergency responses across Wales arrived within eight minutes. The Welsh Ambulance Service target was 65%.
The review, carried out by academic Professor Siobhan McClelland, calls for paramedics to have extra training on patient care and an end to the eight minute target response time.
Three different models are put forward for the future of the ambulance service in Wales.
- Turn the Welsh Ambulance Service Trust into a board and give it an equal with the other health boards.
- Keep the present relationship with health boards commissioning services but with clearer procedures.
- Abolish the trust and give ambulance responsibilities to each of the health boards, although the report has highlighted the legal difficulties with this option.
The report also states that health boards have to stop using ambulances for non-urgent patient transport.
The Welsh Government has not commented on the review although Health Minister Mark Drakeford will debate the report with AMs next week.
Shadow Health Minister Darren Millar said: “This is the latest in a long line of ambulance service reviews and we now need to see some swift action from the Welsh Government to address the problems it identifies.
“The report’s recommendations give significant food for thought but it is important that these are considered alongside other challenges facing our NHS and the way in which it delivers emergency care.
“Scores of ambulances are stacked up outside our emergency departments, response times have fallen to a disgraceful low, and unwanted hospital closures and downgrading are set to increase ambulance travelling times and make the situation worse. Patient care and safety is being put at risk.
“I urge the Minister to use the report to inform his work with stakeholders to improve the ambulance service as a matter of priority.”