Health correspondent, Wales
Hundreds of patients were missed by the Wales Air Ambulance over the past two years because resources were in the wrong place at the wrong time, the charity has claimed.
Chief executive Sue Barnes said the poor road network around two bases in Welshpool, Powys, and Caernarfon, Gwynedd, along with a lack of overnight coverage, meant resources were under-utilised and must be merged on a new site.
She said 551 patients treated by the ambulance service in the two years could not get an additional air ambulance response.
Plans to merge the two bases have met stiff opposition from campaigners who said the strength of feeling had only deepened, despite their failed legal challenge to stop it.
The Wales Air Ambulance has another two bases – in Dafen, Carmarthenshire, and Cardiff.
Each base has a helicopter and car but only Cardiff is operational 24 hours a day, the others run 07:00-19:00 or 08:00-20:00.
Ms Barnes said a 2020 audit revealed “we were missing a significant number of patients” in mid and north Wales, mostly in the evenings and overnight.
From 2022-2024, of the 632 people who met the criteria for an air ambulance, the charity only saw 81.
This compared to 983 in south Wales.
Analysis showed there were 360 shifts between January 2023 and December 2024 where no patients were seen by crews in Welshpool and Caernarfon, compared to 32 in Cardiff and Dafen.
Ms Barnes said “far and away the biggest driver of that disparity” was the staffing hours, but poor road networks around bases was also a factor.
“Now, that’s not good enough… You can see why we felt that the inequity in the service was something that we needed to deal with,” she added.
Ms Barnes said using the helicopter was the default choice in rural areas, but “increasingly we see our aircraft dragged in” to more urban areas in north-east Wales that were “very well-suited to a road response”.
Plans to have helicopters and cars based along the A55 from 2026 would allow them to reserve aircraft for more rural emergencies, she said.
Bob Benyon from Welshpool, who has been heavily involved in a campaign to save the base, said he believed Wales Air Ambulance were “just moving the unmet need from one area to another”.
With no A&E nearby, he said the strength of support in the area was due to “the fact that we need a pre-hospital care system on hand, a few minutes away”.
Some fundraisers previously suggested they would pull their support if the Welshpool site was closed.
Mr Benyon said it was down to people to “follow their moral conscience” but he felt many people may be less willing to support it if the local base closed.
The charity argues that focusing on response times and the perception that it replaces a hospital fundamentally misunderstood its role.
“We’re not a first responder role,” said Ms Barnes. “In virtually every instance we attend, the ambulance service will get there before us.”
She also said it was not a given that the air ambulance would even have come from the nearest base and the emphasis now was on treating people at the scene.
“The overwhelming element is having access to the crew and the right skills, not the minutes and seconds that I think people sometimes think that matters.”
Derwyn Jones has been a critical care practitioner for six years, mainly based at Caernarfon until his recent move to south Wales.
“If I’m bluntly honest it’s a lot busier in south Wales and I feel within this role we need to practise our skillset to maintain competence,” he said.
He described the role as “a bit of a jack of all trades” covering aspects of A&E work, intensive care and anaesthetic departments, all by the side of the road.
Part of his role includes shifts in the 999 control centre to pick out calls eligible for the emergency medical retrieval and transfer service (EMRTS), the specialist crew onboard the air ambulance aircraft and cars.
“It’s really opened my eyes in the last few months, how much we are actually missing in the mid and north,” he said.
Treatment has also changed, meaning response times are “not so much of an issue” with paramedics providing “a first wave of care,” followed by EMRTS.
Alongside critical care practitioners are highly-trained consultants who cover the shifts on a rota basis in addition to their NHS hospital roles, each of them a specialist in “pre-hospital emergency medicine”.
Mr Jones said since the EMRTS team joined the air ambulance service in 2015, “we’ve reduced mortality and morbidity from blunt trauma by 37%”.
Teams carry general anaesthetic and can even do open heart surgery, but ensuring the patient is taken to the most appropriate hospital is another vital part.
In the past, patients would be taken to a nearby hospital and have a CT scan before it was known if they needed to be moved to a major trauma centre.
Mr Jones said that could take up to six hours, whereas now “if we do take that 20 minutes longer to get to scene, they are still within our major trauma centre within an hour and a half – with the addition of having critical care on the roadside and in flight or in the car”.
In the past, patients would be taken to a nearby hospital and have a CT scan before it was known if they needed to be moved to a major trauma centre.
Mr Jones said that could take up to six hours, whereas now “if we do take that 20 minutes longer to get to scene, they are still within our major trauma centre within an hour and a half – with the addition of having critical care on the roadside and in flight or in the car”.
About 13 calls a day – 1% of the total calls – to the Welsh Ambulance Service are eligible for this specialist care.
In July 2021 Laura Davies’ husband Arwel and seven-year-old daughter Sofia were among them when they were involved in a crash not far from their home in Llanwrda, Carmarthenshire.
Air ambulances from Cardiff and Welshpool were sent, along with a road crew from Dafen, but Arwel died at the scene.
Laura asked if her husband would have been saved if he had made it to hospital and, in talks with the after-care team, she said she was able to understand the treatment he got at the scene “was the same as any hospital could have delivered”.
She added: “It was a huge comfort, it does help process the loss and certainly helps answer lots of questions I had.”
She said the empathy of the “real life superheroes” was part of the reason she got involved as a charity trustee.
While medical staff are supplied by NHS Wales, funding for everything else is done by the Wales Air Ambulance charity.
“The care that was extended to myself and my daughter when we were transported to the Heath [hospital in Cardiff] was incredible.
“I was overwhelmed, I was terrified and they literally just held my hand through the process.”
