Written Statement - Out of Hospital Cardiac Arrest Plan for Wales

A patient’s chance of surviving an out of hospital cardiac arrest (OHCA) decreases by an estimated 10% with every passing minute. Between April 2016 and March 2017, the Welsh Ambulance Service responded to 5,800 OHCA of which 2,832 resulted in a resuscitation attempt. Survival rates are low but there is the potential for many more lives to be saved if cardiopulmonary resuscitation and early defibrillation were undertaken more often.  

Last December, I issued a written statement highlighting the progress we have already made in Wales in raising the awareness of the importance of life saving skills such as cardiopulmonary resuscitation and the use of automated external defibrillators, particularly in schools.

The statement acknowledged the existing and continuing work of the Welsh Ambulance Service NHS Trust (WAST) and its partners on increasing the number of public access defibrillator campaigns and teaching children and young people cardiopulmonary resuscitation (CPR).

In response to the Petition’s Committee report on mandatory Welsh legislation to ensure defibrillators in all public places, we reinforced the Welsh Government’s commitment to developing an Out of Hospital Cardiac Arrest plan. Work has been ongoing to develop a plan with a number of partners including NHS Wales, fire service, police, education and third sector organisations.

I am pleased today to announce the publication of the Out of Hospital Cardiac Arrest (OHCA) plan. The plan focuses on the key parts of the Chain of Survival:

• Prompt recognition and call for help 
• Early CPR to buy time 
• Early defibrillation to restart the heart 
• Rapid access to advanced resuscitation 
• Prompt, high quality post resuscitation care 
• Transport to the nearest appropriate hospital 
• Co-ordinated rehabilitation services 

It is anticipated, as part of the on-going implementation of this plan, that further work will be undertaken to include mapping out the organisations that provide CPR training within communities across Wales. Effective partnership working will mean people in Wales are not only given every opportunity to survive a cardiac arrest, but they are also provided with CPR skills and resources such as defibrillators enabling them to save lives.

I would like to thank all of those who have worked together and been involved in the development of this plan.

The Emergency Services Collaboration Working Group is already facilitating good partnership working between the Welsh ambulance services, police forces and fire and rescue services in response to OHCA, and the existing national strategies should be actively built upon. We are committed to improving the survival of people who suffer a cardiac arrest in Wales. The success of the plan depends upon the commitment and action of many individuals and organisations.

Last year, I agreed with the Cabinet Secretary for Communities and Children, a set of priorities for Fire and Rescue support to the NHS.  The priorities focus on the three key areas of prevention, community resilience and emergency medical response. This includes models where fully-trained and equipped fire crews attend and respond to OHCA until the arrival of ambulance services. Such models have been shown to improve response times and patient outcomes whilst also reducing costs. There are already a number of projects across Wales where firefighters attend such incidents and work in partnership with the ambulance service in this way.

The OHCA plan highlights the advantage of promoting life saving skills within schools and confirms all learners in Wales can learn about emergency aid procedures through Personal and Social Education (PSE). This forms part of the basic curriculum for all registered children and young people in maintained schools. It is up to individual schools to decide if this is appropriate for the learners. Additionally, third sector organisations provide training and resources to aid CPR training both in schools, and for the wider population.

The OHCA plan also recognises how effective defibrillators can be and the impact they can make in terms of survival in the event of a cardiac arrest. I would encourage all organisations and communities, if they have not already done so, to register their defibrillators via the Welsh Ambulance Service webpage (external link). Defibrillators locations across Wales can be found at NHS Direct (external link).

We never know when we might come across situations where action needs to be taken to help save a family member, friend, colleague, neighbour or stranger. Providing skills and knowledge would enable people to start the chain of survival as early as possible and give individuals who suffer an OHCA the best chance of survival. We need to ensure these opportunities are available to all people, in all communities across Wales.

The Plan is available for download.