Welsh Air Ambulance Judicial Review Dismissed

On 19 June 2025 Mr Justice Turner dismissed a judicial review of the controversial decision by the NHS in Wales to restructure its air ambulance service (known as the Emergency Medical Retrieval and Transfer Service (“EMRTS”)). EMRTS is separate from the normal ambulance service, and is deployed in only the most serious cases (approximately 1% of 999 calls).

The decision involves the consolidation of two of the four existing bases at Welshpool and Caernarfon into a single site in North Wales. The main rationale for the decision – which is intended to be cost neutral – is that it will result in the service meeting more need across Wales than is currently the case. However, the Claimant (and those supporting her) are concerned that the decision disadvantages those who live near the bases which are due to close.

The Claimant’s primary argument was that it was irrational for the Defendants to have made the decision without also taking into account the costs of a decision made at the same time to develop a commissioning proposal for a bespoke road based critical care service in remote areas to enhance the core service model. The Claimant contended that this was required mitigation for the decision. In contrast, the Defendants maintained that it was a separate proposal concerning the general ambulance service (rather than EMRTS) which was not required to make the decision to restructure EMRTS acceptable. In accepting the Defendant’s submissions on this point, the court stressed that the correct approach to reading a public authority’s decision-making documentation is one of substance over form. See the specific observations made in this regard at [116], which will be of interest to all judicial review practitioners:

1. Care should be exercised to avoid embarking upon a minute textual exegesis of the wording of all documents generated in the lead up to the making of a decision at the expense of discerning the broader factors underlying the reality of the process involved and the central purpose of the exercise in the context of which the decision fell to be directed. The reviewing court must, at the conclusion of its journey, be satisfied that it has been able to see the wood for the trees;
2. The exercise of such care is particularly appropriate in cases, such as this one, in which the volume of documentation involved is very considerable and the opportunities for the detection of infelicities in the choice of language and ambiguity of expression are necessarily broadened;
3. The choice of words must be seen in the context of the particular purpose or purposes for which the relevant document was generated and the role, expertise and depth of knowledge of its author. Not all documents or sources command equal status in the exercise of forensic interpretation.

The court also dismissed the Claimant’s arguments that there had been a breach of consultation requirements and the public sector equality duty.

The judgment can be accessed here.

39 Essex Chambers' barristers Fenella Morris KC and Katherine Barnes acted for the successful Defendants, instructed by Sarah Whittle and Holly Spencer-Biggs at Blake Morgan.