In 2011, Jillian Skinner, the NSW Minister for Health, commissioned a strategic review of the NSW Ambulance Service, including its aeromedical operations. Ernst & Young were engaged to assist with the review; and delivered a final report with 56 recommendations that were released for public comment from December 2012 to mid March 2013. Following consideration of the 73 submissions received, and further consultation with clinical and aviation experts, in 2013 the NSW Government released the "Reform Plan for Aeromedical (Rotary Wing) Retrieval Services in NSW". Along with other reforms, two key issues impact the ongoing operations of the WLSHRS: