Decision to reconfigure Wales Air Ambulance bases lawful; Blake Morgan act for successful Defendants

Background of the case

EMRTS provide a highly specialist pre-hospital critical care service in partnership with the Wales Air Ambulance Charitable Trust (who were an Interested Party in the proceedings) across the whole of Wales. The service is a secondary response service, staffed by consultants and critical care practitioners, sent to a very limited number of 999 incidents (around 1% of all 999 calls). The service has access to four helicopter across Wales, as well as Rapid Response Vehicles and is distinct from the traditional emergency ambulance (which is the primary response service).

A strategic review was carried out by EMRTS and Wales Ambulance Charitable Trust in 2022 to explore the efficacy of the service. It became clear that work was required to ensure to continue to improve the EMRTS service, including in relation to demand and capacity, and to provide an enhanced service.

After several months of engagement, on 23 April 2024 the JCC approved the following recommendations:

• Recommendation 1 – The Committee approves the consolidation of the Emergency Medical Retrieval and Transfer Services currently operating at Welshpool and Caernarfon bases into a single site in North Wales.
• Recommendation 2 – The Committee requests that the Charity secures an appropriately located operational base in line with the findings of this Report.
• Recommendation 3 – The Committee requires that a joint plan is developed by EMRTS and the Charity, that maintains service provision across Wales during the transition to a new base and that this plan is included within the Committee’s commissioning arrangements.
• Recommendation 4 – The Committee approves the development of a commissioning proposal for bespoke road-based enhanced and/or critical care services in rural and remote areas.

Grounds for Judicial Review

The claimant, a resident of Bryncrug near Caernarfon, sought to challenge the JCC’s decision made on 23 April 2024 on the following grounds:

• Ground 1: Irrationality

The claimant argued that the JCC acted irrationally by approving the recommendations without fully understanding the implications of the proposed changes, particularly regarding the costs associated with the new service model.

• Ground 2: Breach of Tameside Principle

The claimant contended that the JCC failed to adhere to the Tameside principles, which require decision-makers to ensure they are properly informed before making significant decisions.

• Ground 4: Consultation Issues

Concerns were raised regarding the adequacy of the consultation process, particularly the failure to consider representations from the Citizen Voice Body for Health and Social Care (Llais).

• Ground 5: Equality Act Breaches

The claimant argued that the JCC failed to comply with the Public Sector Equality Duty (PSED) under the Equality Act 2010, specifically regarding the potential adverse impacts on vulnerable populations.

The Judge refused permission for the claimant to challenge on Ground 4 however, the claimant renewed their application for permission and the parties agreed for the application to be dealt with at the hearing on a rolled up basis.

Conclusion

Ultimately, the court found that the challenges raised by the claimant did not have merit, and the JCC’s decision to reorganise EMRTS services was upheld.

In respect of the arguments relating to irrationality and the Tameside duty, the court found the recommendations sufficiently distinct, with no requirement to finalise every detail before proceeding.

In respect of consultation, the court concluded that, considering the entire engagement process, public and stakeholder views were sufficiently taken into account and the legal requirements for consultation were met. On this basis, the court refused permission for ground 4 to proceed.

Considering ground 5, the court found that multiple Equality Impact Assessments were undertaken, with potential impacts considered and weighed against the benefits of reduced unmet need.

The case highlights the complexities involved in public health decision-making and the balance required between operational changes and community concerns. The court emphasised its role was to ensure fair process, not to second-guess the substantive merits of administrative decisions, providing useful guidance going forward.

Blake Morgan are pleased to have supported their Health Boards clients throughout the challenge and to have secured an outcome that allows them to move forwards with the decisions taken in April 2024.

If you have any judicial review queries you wish to discuss, please contact Sarah Whittle.