Wales Air Ambulance has welcomed the decision to close its bases in Caernarfon and Welshpool.

They say the NHS Wales decision to move forward with improvements to the service it provides will save even more lives across Wales.

An independent review of the charity’s NHS medical partners, the Emergency Medical Retrieval and Transfer Service (EMRTS), identified that on average, there are two-three people every day in a life or limb-threatening situation who need the service, but who currently do not receive it (known as unmet need).

North Wales and the northern parts of mid Wales are disadvantaged at night as the service currently only has one overnight crew, based in Cardiff, covering the whole of Wales.

The service’s medical teams based in Welshpool and Caernarfon are underused.

The review sought to resolve these issues by examining the most effective and efficient way of delivering the service and looked at over 200 options over an 18-month period.

A charity spokesperson said: “The final recommended option was approved by the Joint Commissioning Committee this morning.

“This major service improvement will see the current crews and existing assets in Caernarfon and Welshpool come together in a new base located in the middle of north Wales, near the A55.

“Reflecting demand in the regions, one crew will operate 8am until 8pm. A second crew will operate between 2pm and 2am. Alongside the current highly utilised resources in Dafen and Cardiff, clear evidence shows that this development would see improvements for all parts of Wales.”

Speaking on behalf of the charity’s trustees, Chief Executive Dr Sue Barnes said: “This review was important as lives are currently under threat. It is vital to address the issues of unmet need, inequity and service underuse.

“The inequity is clear to see when we look at the number of incidents our service was unable to attend in Powys and North Wales, between the hours of 8pm and 2pm, during this 18-month review process. 310 incidents. That is not a hypothetical figure and these are not hypothetical cases. These are real patients with very serious and life-threatening conditions.

“Sadly, some of these patients will have died.

“Why were we unable to atend? Because, at present, our service is not being delivered in the most effective way.” Some communities in north, mid Wales and north west Wales shared their anxieties about a potential change during the review’s three periods of public engagement.

Dr Barnes said: “Throughout this process, we consistently said that we aim to ensure any independent recommendation put forward can enable us to guarantee that charitable donations are used in the most effective, patient-focused way. This means saving as many lives across Wales as possible, and in doing so, making sure that no community is materially disadvantaged as a result of any changes. “We want to thank the communities in the northern parts of mid Wales and north west Wales for the incredible passion they have shown for the charity.

“I want to reassure you that you are not losing a service. There is no credible evidence whatsoever to suggest patient outcomes in your areas will be negatively impacted as a result of this development.

“Also, rumours are circulating that we will be removing an aircraft from our primary fleet. That’s not the case. The service will continue to be delivered with four helicopters and a fleet of rapid response vehicles.

“This is an improvement for all parts of Wales, particularly mid and north Wales who will be gaining a more local overnight service – something they don’t have at present. To put that into context, that is 750,000 people who have to rely on an available response from Cardiff after the hours of 8pm. This solution allows us to remedy that at no extra cost to the people of Wales.

“However, we strongly empathise with the genuine concerns and anxieties that have been expressed about wider NHS Primary and Secondary care provision in these regions. As a very small and very specialist service, we are a small cog in the wider machinery of pre-hospital emergency care.

“There is very little we can do to address many of those concerns and nor should we be responsible for covering gaps in NHS provision.

“We have raised this with the Chief Ambulance Services Commissioner and he has reassured us that these issues have been passed on to the appropriate NHS representatives for their information and action.”

Dr Barnes continued: “We have respected the independence of the process, having no direct involvement in the Review and avoiding commentary on it. This has been difficult for us. In the course of 18 months, it has been impossible not to notice and reflect on some misunderstandings about our service and the way that it is delivered. It’s important that we address this as it will help the understanding of how the service will be improved by this development.

“We now invite our supporters, partners, community representatives, and political representatives to work with us in maintaining a sustainable charity for the here-and-now, and for our future generations.

“The review process must be evaluated to identify any improvements for future reviews. Making improvements to a gold-standard service should not be this cumbersome. Equally, it’s vital that we continuously evaluate this service development to make sure that it is delivering the benefits we believe it can.

“We are committed to being involved in these evaluations.” For over 23 years, the public has put their trust in the charity. That trust has allowed the charity to create one of the largest air ambulance services in the UK and one of the most medically advanced in Europe.

The charity, which has attended over 49,000 missions since 2001, needs to raise £11.2 million every year to operate and maintain its four helicopters and fleet of rapid response vehicles.

Dr Barnes said: “We appeal to our supporters to trust us once more as we work with our medical partners to further improve our lifesaving service for the benefit of everybody in Wales.

“Our commitment is, and always will be, to deliver the best possible care, with the resources available to us – wherever and whenever it is needed.

“We exist because of you and with your support, our charity will be there for you and your community – now and always.”

In conclusion, Dr Barnes said: “As highlighted in today’s JCC meeting, this is the start of a journey to reduce unmet need across Wales. There is more than we can do and we will work with all partners and stakeholders to ensure that we can save as many lives as possible.

“We will start work immediately on the planning for a new facility. We will do this with the involvement of our service’s medical and aviation colleagues to create a site that meets their needs.

“We believe that a new base operation will be achievable within the next few years.”

For the full report by the Chief Ambulance Services Commissioner, visit https://easc.nhs.wales/engagement/sdp/.