Ambulance crews and 999 call handlers walked out on Wednesday as a union chief admitted the strike would lead to more patient harm.
With the Government and unions having failed to make a breakthrough on a pay row, the industrial action by ambulance staff started at 11am in London, where hospitals issued alerts over maternity services and the pressure on A&Es.
Up to 25,000 ambulance workers across England and Wales, including paramedics, call handlers, drivers and technicians from the Unison and GMB unions were taking part in staggered strikes across a 24-hour period.
Unison head of health Sara Gorton stressed it was being “as responsible as we can in managing” the strike. But she admitted on TimesRadio: “Every single day in the ambulance service, avoidable harm is happening. That is one of the motivations for the strike. Unfortunately, on a strike day, that is more likely.”
Health Secretary Steve Barclay said an agreement had been struck with the unions for paramedics to respond to the “most serious” calls, in terms of “life-threatening” situations.
“But it is clear that there will be disruption in terms of other calls for ambulances,” he added. “In terms of those calls, sometimes what may be initially a less serious case, can become more serious where there is a significant delay in that treatment.”
He stressed that talks went on until midnight on the level of cover by ambulance crews during the strike. Wednesday’s stoppage is expected to be more disruptive than the first one on December 21 as 999 call handlers were joining paramedics on the picket line.
Several NHS trusts in London warned that patients would face “extremely long waits” for non-emergency care as ambulance workers this morning began their 12-hour walkout across the capital.
Unison members at the London Ambulance Service are among the thousands of paramedics, call handlers and support staff walking out across the UK in a dispute over pay. But Daniel Elkeles, chief executive of the LAS, said Category One calls, including cardiac arrests, and serious Category Two calls for “life and limb conditions” — including strokes, heart attacks and sepsis — will still be responded to.
He has urged people only to call 999 for “life or limb-threatening” situations.
NHS England has said that 111 should be the “first port of call” for any condition that is not life-threatening.
Unions insisted patients whose condition worsens could be escalated for a quicker response and that paramedics and call handlers were prepared to come off the picket line to respond to surge in life-threatening situations.
Barking, Havering and Redbridge University Hospitals NHS Trust said the strikes would pile “further pressure on our already busy hospitals, particularly our emergency departments”, adding: “Anyone coming to our departments who does not need emergency care will face extremely long waits”.
Lewisham and Greenwich NHS Trust said that delays meant that clinicians could not “guarantee a quick journey into hospital should you need it during an emergency for you and your baby”.
And St George’s NHS Trust warned patients that an ambulance “may not be able to attend to you at home in an emergency or in labour”.
“Make sure you have plans to get to hospital using private transport like car or taxi,” the trust said.
Dr Mark Harmon, an A&E doctor and Clinical Entrepreneur at eConsult, said that “already burnt-out staff and patients in need of critical care” would suffer the most during Wednesday’s industrial action. “The sad reality is that even without the ambulance strikes, A&E departments are no longer just cracking at the seams. We’re at breaking point.”
Mr Barclay has criticised the unions for not agreeing a nationwide level of cover during the ambulance strikes.
Speaking on GB News, he said: “We are working closely with trade union partners in terms of the contingency plans that are being put in place but clearly there will be an impact today on patient responses and that is very concerning. We are saying to people if they do face genuine life-threatening issues, then of course the response is to phone 999, but if not then to be very mindful of the pressure on the system today.
“Clearly, there is 111, which is there for urgent calls.”
Ms Gorton said unlike the Royal College of Nursing action, the ambulance dispute was a “lot more complicated” as it involved several unions at a “range of different types” of ambulance services.
“So the fine detail has to be worked out at a local level,” she added.
She said the strike had to have an “element of impact” but was directed at the organising and planning of the system, while maintaining “life and limb” cover.
