Positive steps have been taken by the Welsh Ambulance Trust to solve the very serious problems it faces, but significant challenges still need to be resolved, according to a new report.

The Welsh Assembly’s audit committee’s Review of Ambulance Services in Wales, published on Tuesday, concludes that the trust’s modernisation plan will help deal with some of the organisational and systematic challenges required, but rapid and sustained progress will take time.

A range of internal problems that remain barriers to improvement are highlighted in the review, including: * Low staff morale;

* Disappointing progress in improving quality and capacity of line management;

* Unacceptable aspects of performance, despite overall improvements in ambulance responses;

* Lack of a detailed estate strategy and problems with buildings.

The report recommends an action plan specifically designed to improve staff morale through better communication and addressing perceptions of bullying and harassment.

It also recommends improving communication technology aboard ambulances as a key priority and states the Assembly should urgently decide upon the trust’s business case for these technologies.

The report chronicles serious target failures, A&E turnaround delays, management failures and delivering patients to the wrong address.

But, it does refer to the appointment of a new fleet manager and a £23m investment in 151 new vehicles.

With Assembly support, the trust is required to make efficiency savings of £17m in 2008-09, rising to £23m in 2009-10.

But initial indications show there could be a shortfall of £6m between any additional funding from Health Commission Wales and the £9m estimate to deliver minimum standards.

The worst problems remain in south east Wales.

Chairman Stuart Fletcher was praised for his strong leadership through the delivery of the review.