Written Statement - Implementing the Out of Hospital Cardiac Arrest Plan for Wales

Members will know that I am committed to improving people’s chances of surviving an out of hospital cardiac arrest. To support this aspiration, in June of last year, I launched the Out of Hospital Cardiac Arrest plan for Wales. This is an ambitious plan which will see the general public, the third sector, emergency services and health care professionals working together to respond to people having cardiac arrests in the community.

As the Welsh Ambulance Service once again launches its annual Shoctober and Restart a Heart Day campaigns, it seems an appropriate time to update Members on progress in implementing the plan.

It is a sad fact that a patient’s chance of surviving an out of hospital cardiac arrest decreases by an estimated 10% with every passing minute. Survival rates are low but there is the potential for many more lives to be saved, as has been demonstrated by a number of countries which have taken active steps to improve each stage in what is called “the chain of survival”. This is the reason behind this plan and why it is so important that we take concerted action.  

Improving outcomes requires a broad range of activities across the chain of survival, including early recognition and call for help to try to prevent cardiac arrest happening; early cardiopulmonary resuscitation (CPR) to buy time for the patient; early defibrillation to restart the heart and then optimal post-resuscitation care which should ensure a good outcome and quality of life.  

Key to the successful implementation of the plan is the need for partnership. Following the publication of the plan, a collaboration implementation workshop was held in Cardiff last December. Organisations from across the public and voluntary sector came together to agree how the plan would be taken forward. We heard from the Scottish Government about their Save a Life for Scotland partnership, and via video link from Professor Mickey Eisenberg about the work done at King County in Seattle. There was agreement that we should seek to learn from the experiences of other countries here in Wales.  
The feedback from the workshop has been used to develop specific work streams in each part of the chain of survival. These include communications, CPR/Defibrillation, Pre and Post hospital care and Registry/Research.

Whilst progress was initially slower than we would have ideally liked on some aspects of the plan, significant progress has been made in improving pathways within both the Welsh Ambulance service and health boards to ensure once a 999 call is received, people receive the necessary help and support to increase the chance of survival both prior to the paramedics’ arrival and on the scene, before their transport to an appropriate hospital for definitive treatment.

There has also been a steady increase in the number of defibrillators mapped into the Welsh Ambulance Service dispatch system, with 2,763 defibrillators from across Wales now registered.

In addition, the Welsh Ambulance Service has been working with the Wales Cardiac Network and Warwick University to better map the data surrounding out of hospital cardiac arrests. This includes mapping the entire pathway of a cardiac arrest from onset to treatment and discharge from hospital, using data from health boards. By better understanding the pathway of care, this data will help to bring about consistency in response to out of hospital cardiac arrests.

We are now turning our attention in earnest to some of the more challenging parts of the plan, including how we can build a strong cohort of the general public who, following suitable training, could take confident action when someone is having a cardiac arrest. I am pleased to announce today we will be establishing a partnership, similar to the one in Scotland, called Save a Life Cymru, Achub Bywydau Cymru in Welsh.

This work will build on the sterling efforts already made by the Welsh Ambulance Service to teach CPR in schools - last October during the Start a Heart Campaign, nearly 13,000 schoolchildren were taught CPR.  Save a Life Cymru will lead the work improving access to CPR training and defibrillation. We are inviting all third sector, public and other organisations with an interest to become a member of the partnership and work with us to lay the foundation for building lifesaving activity across the country.

Save a Life Cymru will highlight and encourage the work of groups who are already teaching CPR within their communities. Developing local community networks to encourage cross service collaboration, identify communities across Wales who have less CPR training opportunity and to offer support to coordinate larger scale events. Finally, the partnership will promote the campaign to the Welsh public.

This partnership will be supported initially by a full time programme manager to aid its establishment and ensure rapid progress can be made on the first stages of the chain of survival. We are encouraged by the response so far from key stakeholders.

Welsh Government will provide funding, totalling £586,000, for the first two years of the partnership to support the programme manager and necessary communication awareness raising activities.

This will include the development of proactive media, social media, website, promotional items and other content in order to generate a public profile for the work and drive people of all ages to learn CPR.

To successfully achieve the implementation of the plan, we recognise that not only will organisations need to develop their own plans to support delivery; but there needs to be co-ordinated action on a national level.

The tragic deaths over the weekend at the Cardiff Half Marathon highlight how an out of hospital cardiac arrest can happen at anytime and the importance of rapid intervention, even though on this occasion it was not possible to save their lives. I would like to extend my sympathies to the families and loved ones of these two young men and thank the emergency services, volunteers and bystanders for all their efforts.

My update today outlines the work Welsh Government, NHS and partners have undertaken so far, to create and deliver the first steps in implementing the Welsh Out of Hospital Cardiac Arrest Plan. The funding we have provided reinforces Welsh Government’s commitment to drive forward progress and establish the Save a Life Cymru partnership.

Collectively, we are determined to improve the outcomes of people suffering a cardiac arrest in Wales.

A copy of the OHCA plan can be found at:

https://gov.wales/topics/health/nhswales/plans/heart_plan/?lang=en