Recommendation 4: Update on Rural Response Models

27 March 2026

An update on the ongoing work to review Recommendation 4 – Rural Response Models following recent discussions at the NHS Wales Joint Commissioning Committee (NWJCC) – March 2026. 

The NHS Wales Joint Commissioning Committee (NWJCC) has considered an update on Recommendation 4, which focuses on improving access to urgent and emergency clinical care for people living in rural and remote areas of Wales. 

Recommendation 4 originated from public feedback during the Emergency Medical Retrieval and Transfer Service (EMRTS) Service Review and aims to develop a commissioning proposal for bespoke road‑based enhanced clinical care services in rural and remote communities. 

Joint Committee Members previously endorsed commissioning intentions linked to this recommendation, although progress on the work was paused during the Judicial Review. 

At its most recent meeting, held in public on 17 March 2026, the Joint Commissioning Committee noted that Recommendation 4 is entirely separate from decisions relating to air ambulance base configuration, reflecting the position confirmed through the Judicial Review. 

Members also received updated information on anticipated timelines for the consolidated air base, which confirmed that there is a longer planning window available to consider next steps on Recommendation 4.  The Wales Air Ambulance Charity continue to provide regular public updates on the implementation of their move from Caernarfon and Welshpool bases to a new consolidated base in north Wales. Service Improvement - Wales Air Ambulance  

The Committee discussed early analysis of published ambulance performance data under the updated Ambulance Performance Framework. At this stage, the analysis does not demonstrate a clear or consistent difference in ambulance performance between rural and urban areas, with a mixed picture across Wales. 

Therefore, following discussion of the available options, the Joint Committee did not support the option to cease development of Recommendation 4 and reaffirmed its commitment to progressing the recommendation. Members agreed to progress further engagement and development work. This will include renewed engagement with communities and stakeholders across rural Wales, continued collaboration with providers – specifically the Welsh Ambulance Services University NHS Trust – and Health Boards, alongside further work to clearly define the needs to be addressed and the ambulance service models that could best meet those needs. 

The Joint Committee will continue to receive progress updates through its usual governance arrangements. 

Details of upcoming meetings and Committee papers are published on the NWJCC website:  Committee Meeting Papers - NHS Wales Joint Commissioning Committee