Patients wait longer for ambulances
More than two out of five patients in desperate need of emergency care in Wales were left waiting for more than eight minutes for an ambulance during August.
Across the country, just 56.9% of ambulances arrived at the scene within eight minutes, according to new data from the Welsh Government.
The figure is down from 58.3% in July and from 61.8% in August 2013.
It also means that the target of reaching 65% of " Category A (immediately life-threatening)" calls within eight minutes was breached.
Across the country, there were 36,101 emergency calls, with 14,067 of these deemed to need immediate care.
The ambulance service in Wales came under intense fire last week after it emerged that a grandmother died while waiting in a queue of ambulances outside a hospital.
Sonia Powell, 73, was taken to Morriston Hospital's accident and emergency unit in Swansea, south Wales, following a suspected heart attack.
Her family said she had been waiting "at least an hour" by the time she died.
Health officials, who say the wait was around 40 minutes, have now launched an investigation.
Wales's shadow health minister, Darren Millar, said the latest and "dire" figures were "particularly worrying" given the warm, dry summer.
He added: "Urgent answers are needed from Labour ministers as to how they have left this to go on for so long and what action they intend to take to put it right."
Those sentiments were echoed by Plaid Cymru AM Elin Jones.
She said: "Despite the Health Minister's promises, the figures published today show that 43% of patients waited longer than the target time - a figure that is much too high.
"This is a long-standing failure by the Labour Welsh Government and is indicative of fundamental problems throughout the emergency care system. The problem is not confined to the ambulance service."
Ms Jones said fundamental changes to the way the health service is run needed to be made.
She added: "We need to better support paramedics, and plan for the future workforce. Lessons need to be learned from the approach taken in Scotland, which had performance at the same level as Wales back in 2007. However they have improved performance significantly over subsequent years."
Mike Collins, director of service delivery at the Welsh Ambulance Service, insisted improvements were being made.
He said: "Since April the Trust has recruited 79 extra staff into its workforce across Wales, including 21 paramedics, nine of whom went operational in July and 12 of whom went operational on Monday.
"Twelve Higher Education Institute paramedics are expected to be operational from December. The trust has also recruited 46 staff into its urgent care service, all of whom will be operational in mid November.
"In addition, a further 21 paramedics will be appointed in the coming weeks and are expected to be operational by February, and 48 emergency medical technicians will also be officially appointed, some of whom will be operational by December and the remainder by next April.
"We anticipate these extra staff will help us to improve our performance and provide a first rate ambulance service for the people of Wales.
"The emergency healthcare system across Wales is under significant pressure and demand for our service remains very high. We recognise that on occasion we fall short of the eight-minute target but are working as hard as we possibly can to get to patients as quickly as possible."
Mr Collins also urged the public to heed the warnings in the recent Choose Well publicity campaign to help relieve pressure on the ambulance service.
He added: "NHS Direct Wales, out-of-hour GP services and pharmacies are all available for healthcare and advice for minor illnesses and injuries. Please remember only to dial 999 if someone is seriously ill or injured, or their life is at risk."
Meanwhile, the Welsh Government admitted the figures were "disappointing".
A spokesman said: "They are not where either the Welsh Ambulance Services NHS Trust, health boards, the Welsh Government or the public would want them to be.
"However, an analysis of these figures shows they are an improvement on the service's performance in five of the past six months and the difference in the median response time in August compared to that in July is a matter of just eight seconds."
The Welsh Government also said the service was undergoing a period of change - and a a new interim chief executive was due to start on October 1.
Earlier this week, it was announced that current chief executive Elwyn Price-Morris was stepping down due to "ill health".