ABUSE, saving lives, frustrations, and delays are all part of a normal day for one of the Welsh Ambulance Service’s newest paramedic roles.

The Cymru High Acuity Response Unit (CHARU) is one of the latest innovations from WAST in an attempt to ensure patients with immediate risk to life are seen as soon as possible.

There are currently over 100 CHARU Paramedics across Wales, whose role is to attend the most serious calls received by the service, such as road traffic collisions and cardiac arrests.

With emergency ambulance crews often tied up outside hospitals, there is an even greater importance on the likes of Rob Heaton to respond to those life-threatening calls.

Rob, from Wrexham, joined the NHS in 2008 before becoming a paramedic with North West Ambulance Service in 2012.

After four years there he joined the Hazardous Area Response Team (HART) as a paramedic, where he worked for six years.

He has now been with WAST for just over 18 months, first serving as a paramedic before moving into the CHARU role.

“The main difference in the roles is the experience and confidence you need being on your own," said Rob.

“You’re in a solo role and can often be the first on the scene.

“With the current delays, you can sometimes be waiting quite a while for backup to take patients into hospital.”

Ambulance delays are one of the key issues faced by WAST at the moment, with large quantities of vehicles and crews tied up caring for patients outside hospitals.

The Leader: Rob travels on his own in a high response carRob travels on his own in a high response car (Image: NQ staff)

This leads to queues of ambulances lining up outside hospitals like the Maelor and Glan Clwyd and people waiting hours for an ambulance elsewhere in the community.

This is much to the frustration of WAST’s workers and volunteers, with numerous hour-long waits “normal” according to Rob, who added:  “We can’t always provide the service for people that need it, as unfortunately, we sometimes have people calling for ambulances that don’t always need them.

“They think it’s an infinite resource, but it’s not.

“I’ve been called out to people saying they can’t breathe, or are having seizures, but when I get there, that’s not the case.

“We need the public to be honest about their symptoms because what can happen is emergency ambulance crews can get tied up in one location, while there is another patient waiting in the community who needs us immediately.

Rob also believes that the current state of ambulance delays, which can sometimes lead to staff waiting up to 24 hours at hospital sites like the Maelor, is affecting the staff levels at WAST.

He said: “Some people are no longer staying in the job.

“They are coming out of Uni with these degrees, doing two years, and moving on.

“People sign up for the job because they want to help people and respond to emergencies, they don’t want to be outside A+E for hours on end, and their skills can begin to fade as they’re not using them.”

Despite the delays and frustrations, Rob and his colleagues at WAST continue to provide the best service they can to those in North Wales.

Having spent a day with him last week, I saw first-hand the amazing work they do.

After a quiet start to his 6am-6pm shift, Rob was placed on his 30-minute lunch break at 9am, just before returning to Dobshill a RED call came in about a middle-aged person with chest pains.

The blue lights were on as we made our way to the scene. Upon arrival, Rob examined the patient, made them comfortable and requested for an ambulance to come and take them in for further treatment.

Ten minutes later, an ambulance arrived, two paramedics loaded the patient into the ambulance and transported them to hospital.

“That’s how the service should work, that is a perfect example of what should happen.

“They were right to ring 999, it was appropriate for me to respond due to the nature of the call, I stabilised the patient and the ambulance arrived shortly after to take them in.”

Within an hour of making the call, the patient was on their way to the hospital, after being checked at home first. However, that isn’t always the case.

“There are times when I have completed my observations at home and could be waiting a couple of hours for an ambulance.

“That’s where the frustration over delays comes in, but you’ve seen a perfect example of how the service should be used.”

Once the necessary note-taking was complete, it was back to Dobshill for ‘lunch’ at 10.45am.

Ten minutes into the only break in Rob’s 12-hour shift, a RED call came in reporting a person in cardiac arrest.

We rushed to the car, where Rob and the site Duty Operations Manager set off to the address.

We arrived within five minutes. Every minute is crucial with a call like this. Ten minutes later, two more paramedics arrived in an ambulance, and by 12pm the person was stabilised and on their way to hospital.

“Every second and minute counts in situations like that, so it’s pleasing we were free to respond.

“Sadly, it doesn’t always happen like this, especially if we’re tied up with non-emergencies elsewhere.”


To witness something like that was quite moving, how the staff switch into a life-or-death situation.

Not many people have to deal with incidents like that in their day-to-day lives, something that Rob admits can be damaging when receiving abuse in the role.

He said: “At the end of the day we are human, one experience that sticks out for me was on Christmas Day, years ago I was performing cardiopulmonary resuscitation (CPR) on a young child, before having to go to a person who had called an ambulance for a lower acuity call.

“On arriving at the location, they got aggressive with me.

“You never know what you’re going to see or experience and of course, we’ll always be professional, but we can see some horrific things.

“I’ve been punched, kicked, held hostage, and even had a knife pulled on me trying to do my job.

“I’ve also known colleagues who have been sexually assaulted in the back of an ambulance trying to help someone.