DOUBLE the current level of ambulance cover is needed in parts of Gwent to meet emergency demand, an action plan has revealed.

But sufficient paramedic and other ambulance staff to fully operate new demand-led rotas for the area will not be in post until next April.

The joint Aneurin Bevan University Health Board and Welsh Ambulance Services NHS Trust plan to ease pressure on A&E units and ambulances highlights Torfaen as an area where a doubling of emergency vehicles is needed.

But analysis has confirmed the whole health board area is the worst in Wales for demand for ambulance services compared to resources available.

That will come as little surprise to residents of Torfaen, and also Monmouthshire and Blaenau Gwent, where performance against eight-minute emergency ambulance response time targets remains stubbornly low.

These three areas recorded the three worst such performances in Wales during October and have been among the poorest regularly this year.

In September, the trust confirmed that in Gwent, and for the first time in Wales, it was using private ambulances to attend some weekend emergencies, due to staff shortfalls.

That arrangement has continued through the autumn, and though seven new paramedics have recently begun work, there remain five paramedic and nine emergency medical technician (EMT) vacancies for the health board area. New EMTs are proposed, but not until the spring.

New rotas however, which must also allow for issues such as leave, sickness and training, are predicted to require 38 extra paramedics and EMTs.

The rota project “if done well, will ensure that the ambulance service (in the health board area) can meet current and future demand” states the action plan. It stresses however, that “significant” recruitment is required.

What remains uncertain is the effect winter pressures will have on ambulance service performance in the meantime. Health bosses will want to avoid repeats of scenes of ambulances parked outside hospitals with patients being triaged on board – as happened at the Royal Gwent in Newport recently – because A&E departments are so busy.

A diversion system has been introduced which involves some patients, where appropriate, being diverted to Ysbyty Ystrad Fawr, at Ystrad Mynach to ease pressure at the Royal Gwent.

Other measures include taking appropriate patients straight to the hospital’s medical assessment unit, bypassing A&E, while extra triage nurses are being employed at Nevill Hall Hospital, in Abergavenny, to help with handovers.

Darryl Collins, ambulance trust head of operations for the health board area, said the need to better align resources to meet demand was recognised and the trust and trades unions were reviewing rosters.

He added that staff were familiar with major incident and adverse weather plans, and the trust was working with other bodies on winter preparations.

Paramedics are being supported by new systems to help them make the appropriate clinical decisions, and he said “our physician response team in the health board area has a doctor embedded with a crew to support clinical decision-making.”

“It’s really important that people help us to care for those most in need by using our services sensibly and remembering that 999 is for real emergencies only,” said Mr Collins.

“We’re using Twitter this year to remind people of the importance of choosing the right service to meet their needs, and you can follow us @WelshAmbulance.”