Ambulance services and hospital trusts have declared “critical incidents” around the country with people being urged to only call 999 in life-threatening emergencies.
The move comes as nurses hold their second day of industrial action, and the day before ambulance staff strike, when thousands of paramedics, technicians, control room workers and other staff walk out.
The wave of strikes are part of weeks of widespread disruption as picket lines form across different industries.
What is a ‘critical incident’?
Critical incidents are declared when local health bosses are concerned they cannot provide critical services for patients, such as emergency care.
The status, which was deployed during the Covid-19 pandemic when faced wit staff shortages, allows them to instigate additional measures to protect patient safety.
This includes seeking mutual aid, cancelling all training to allow for the redeployment of all clinical staff, no longer taking bookings for urgent non-emergency transportation and increasing third-party provider provision.
The services said they took the decision due to pressures including 999 call volumes and hospital handover delays.
Who has declared a ‘critical incident’?
North East Ambulance Service
North East Ambulance Service, which operates across Northumberland, Tyne and Wear, County Durham, Darlington and Teesside, said it declared a critical incident on Monday afternoon as a result of “significant delays for more than 200 patients waiting for an ambulance, together with a reduction in ambulance crew availability to respond because of delays in handing over patients at the region’s hospitals”.
South East Coast Ambulance Service
South East Coast Ambulance Service, which covers Brighton & Hove, East Sussex, West Sussex, Kent, Surrey and North East Hampshire, said it decided to declare a critical incident on Monday “following a period of more than a week of sustained pressure across our 999 and 111 services, significantly impacting on our ability to respond to patients”.
East of England Ambulance Service
The East of England Ambulance Service, which works in Bedfordshire, Hertfordshire, Essex, Norfolk, Suffolk and Cambridgeshire, said it was “currently under huge pressure as a consequence of 999 call volumes and hospital handover delays”.
“Declaring a critical incident means we can ensure our resources are focused on patients with the greatest need, as well as allow us to access wider support from our health and care partners,” the trust said.
Yorkshire Ambulance Service
The ambulance service in Yorkshire said declaring a critical incident would allow it to “protect our core services for patients and respond to ongoing demand”.
Executive director Nick Smith said: “Services will be severely disrupted, with the likelihood of significant delays.
“So, we are urging the public to use the emergency ambulance service more wisely and only to call 999 when someone is in a life-threatening or very serious condition as we prioritise our response to those most in need.”
South Central Ambulance Service NHS Foundation Trust
Portsmouth Hospitals University NHS Trust
A critical incident was also declared at Portsmouth Hospitals University NHS Trust, which said its emergency department was “full with patients that need admission” but that there was “limited space to treat patients with life-threatening conditions and injuries”.
University Hospital Southampton
Nottingham University Hospitals
When are the strikes and who is striking?
The ambulance strikes will take place on Wednesday December 21 and Wednesday December 28.
Members of three unions, GMB, Unison and Unite, which represent around 25,000 ambulance workers, are walking out on a coordinated strike on Wednesday December 21.
The action will involve ambulance workers, paramedics, call handlers and emergency care assistants in 10 out of 11 NHS trusts in England and Wales.
GMB union members will then stage a further strike at nine trusts on December 28.
Why are they striking?
The unions voted to strike in a dispute over the government’s 4% pay award.
It comes as a real terms pay cut with the UK’s current inflation standing at 11%.
Can you get an ambulance?
It is expected that all category 1 calls – the most life-threatening such as cardiac arrest – will be responded to.
Some ambulance trusts have agreed to exemptions with unions for specific incidents within so-called category 2 which covers serious conditions, such as stroke or chest pain.
However, patients in category three – typically including falls – and category four are unlikely to be sent an ambulance during the strikes.
Military personnel are being drafted in to provide support on ambulance calls during the strike but will not drive ambulances on blue lights for the most serious calls.
What should you do in an emergency on strike days?
The Department of Health and Social Care has said advice remains for people to call 999 in an emergency.
Health minister Will Quince urged people to stay safe during Wednesday’s strike, telling BBC Breakfast: “Where people are planning any risky activity, I would strongly encourage them not to do so because there will be disruption on the day.”
The health minister also told the public that in any emergency calling 999 should still be the first option.
“But the key thing is for anybody that does have an emergency situation or a life-threatening situation that they continue to call 999 as they would have done previously, and for any other situation, NHS 111 or NHS 111 online.”