of an appropriate level of urgency, including transport to hospital if the diagnosis merits that action. Community First Responders (CFR) - volunteers from the community trained in basic first aid, oxygen administration and the use of an automated external defibrillator (AED). They are used by the ambulance service mostly in rural areas to provide basic care, such as cardiopulmonary resuscitation (CPR) before an EMS crew arrives. As a CFR is usually only sent to local calls in specified communities, they often arrive before an EMS ambulance crew, even without the use of blue lights and sirens. Whilst most CFR teams are the sole responsibility of WAST, a number of teams (especially in the county of Powys) are made up of regular divisions from St John Ambulance Cymru although this does not give them any exemptions. There are developing numbers of advanced paramedic practitioners in the service who through their extended scope of practice are working toward advancing the service their patients receive with "see and treat" and "see and refer" models of care. This removes the need for some patients to travel in an ambulance to A&E. In 2012, a strategic review of the service was commissioned by the Welsh Government and was conducted by Professor Siobhan McClelland and published in April 2013. See also NHS Wales, the National Health Service in Wales NHS Direct Wales Wales Air Ambulance References External links NHS ambulance services trusts NHS Wales Welsh NHS trusts Ambulance services in Wales