New 999 Call Categories To Improve Patient Care And Ambulance Response

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Further changes to the way 999 calls to the Welsh Ambulance Service are managed will come into force from Tuesday 2 December.

These changes will enable the ambulance service to quickly identify and respond to people with a range of serious, time-sensitive conditions like suspected stroke and heart attacks, which need to be prioritised.

New “Orange Now”, “Yellow Soon” and “Green Planned” categories will replace the existing Amber and Green categories.

This builds on the “Purple Arrest” and “Red Emergency” categories, which were introduced in July for the most life-threatening calls.

From Tuesday, when someone calls 999 in an emergency there will be five new ambulance response categories:

  • Purple Arrest – for people experiencing a cardiac or respiratory arrest who need an ambulance immediately.
  • Red Emergency – for people at high risk of a cardiac or respiratory arrest, for example, someone who is choking, who needs help immediately.
  • Orange Now – for serious conditions, which need face-to-face clinical assessment, tests and transfer to hospital or specialist care – for example, someone with symptoms suggestive of a stroke or heart attack.
  • Yellow Soon – for people who need to be assessed first, either over the phone or face-to-face, before a clinician determines the most appropriate next steps for their care. For example, a person with abdominal pain, or non-serious injury. People could stay at home following treatment, or the ambulance service might arrange transport to a clinic or hospital, depending on the most appropriate course of action for their needs.
  • Green Planned – for less urgent calls, such as someone with a mild infection. People could be treated safely at home with the right care from local services.

The new model will categorise emergency calls by need, not only ambulance response time, aiming to improve people’s outcomes and experiences.

People will be assessed using enhanced clinical triage to better identify their clinical needs and people who need a faster response and transport to the right healthcare facility will be prioritised.

They will be matched to the most appropriate resource, whether that’s an emergency ambulance, an advanced paramedic practitioner or alternatives, such as planned patient transport or self-care.

The changes are designed to safely reduce unnecessary hospital admissions and support care closer to home where that is clinically safe.

By tailoring responses to individual needs, people will receive more timely and effective care.

Cabinet Secretary for Health and Social Care, Jeremy Miles said: “This new ambulance response model is about making sure everyone gets the right care for their complaint or condition.

“By improving clinical decision-making and introducing new response categories, we will deliver better outcomes and experiences for people across Wales.

“The new approach will be evaluated to ensure it is delivering the improvements in patient care which we expect.

“We are seeing positive outcomes from the changes introduced in July and we want to see this system save more lives and provide better experiences for people across Wales.”

Executive Director of Paramedicine at the Welsh Ambulance Service, Andy Swinburn, said: “Calls to the Welsh Ambulance Service have traditionally been categorised as Red, Amber or Green, but it’s become apparent these categories have broadened over time, leading to an inefficient use of ambulance resources.“The current Amber category in particular – which represents around 70% of total demand – doesn’t allow for a more targeted response to serious conditions like a stroke or a fractured hip, which means that some patients wait far longer than any of us would like.

“The nature of how people present to 999 has changed and it’s important to reflect this in the way we respond, first and foremost to increase ambulance availability for those who truly need it but also to ensure that people who can be cared for closer to home get that opportunity.”


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