Hospital and ambulance trusts across the country have declared 'critical incidents' due to 'unprecedented' pressure on their services.
Up to 26,600 ambulance workers walked out across England and Wales today in a dispute over pay.
The strike is set to last 24 hours, with another walkout planned for December 28.
A total of 10 trusts have declared critical incidents so far, with many claiming to have been facing high demand and delays before the strikes began.
The NHS defines a critical incident as "any localised incident where the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed or the environment is not safe, requiring special measures and support from other agencies, to restore normal operating functions."
By declaring the incidents, the Trusts can begin inputting measures to deal with high demand and prioritise the sickest patients.
Here's the full list of all the Trusts to have declared critical incidents so far.
London Ambulance Service
London Ambulance Service has declared a "business continuity incident".
The service said its 999 and 111 services "remain extremely busy" and are urging people to make their own way to hospital if safe to do so, My London reports.
A London Ambulance Service spokesperson said: “We have declared a ‘business continuity incident’ due to the high demand across our 999 and 111 services. In recent days, we have been taking up to 7,000 999 calls every day compared to a pre-pandemic busy day of 5,500 calls.
“We are doing everything we can to prioritise our sickest and most severely injured patients and would like to remind the public that if they need urgent medical advice that does not require an emergency ambulance to go to NHS111 online or call 111 for advice and support.”
East of England Ambulance Service
The East of England Ambulance Service Trust (EEAST), which covers Cambridgeshire, have declared a critical incident due to large amounts of emergency calls and hospital handover delays.
They said that declaring the incident means they can "ensure our resources are focused on patients with the greatest need," CambridgshireLive reports.
They continued: "Our staff continue to work incredibly hard in challenging circumstances, to respond to calls and incidents as quickly as possible. If you need to contact us because of a life-threatening condition or serious injury, then call 999. For everything else, we would urge you to please use 111 online, speak to your GP or use a minor injuries centre."
Cornwall’s hospitals and health and care system
Cornwall’s hospitals and health and care system have declared that they are operating at critical incident level.
Making the announcement on Tuesday (December 20) they blamed 'acute pressure' on all of the health and care services in Cornwall for escalating the operational level to a 'system critical incident', CornwallLive reports.
A spokesperson said: "We are currently seeing a high number of ambulances waiting outside the Royal Cornwall Hospital and a surge in the number of patients in our emergency department and Cornwall’s minor injury units, as well as a large number of patients in Cornwall’s hospitals who are deemed medically fit for discharge but awaiting the right onward care."
People in the local communities have been urged to "help by making sure they make the right choice if they need urgent care, either by seeing a pharmacist, contacting their own GP, even if here on holiday, or by contacting NHS 111 online for advice".
South East Coast Ambulance service
The South East Coast Ambulance service, which attends to patients in Kent, Sussex, and Surrey, declared a 'critical incident' on December 19 after over a week of 'sustained pressure'.
KentLive report that high demand has 'significantly impacted' first responders in the run-up to Christmas.
A spokesperson said: “Declaring a critical incident provides us with additional oversight and enables us to explore options including mutual aid, while focusing all efforts on frontline patient care.”
They added: “SECAmb took a decision yesterday evening (Monday, December 19) to declare a critical incident. This decision was taken following a period of more than a week of sustained pressure across both our 999 and 111 services, which has significantly impacted on our ability to respond to patients.”
North East Ambulance Service
The North East Ambulance Service also declared a critical incident on December 19.
The announcement was made as more than 200 people waiting for an ambulance faced 'significant delays', TeessideLive reports.
Stephen Segasby, chief operating officer at North East Ambulance Service, said: "Our service is under unprecedented pressure. Declaring a critical incident means we can focus our resources on those patients most in need and communicates the pressures we are under to our health system partners who can provide support.
"We are asking the public to call us only in a life-threatening emergency. For all other patients, we are urging them to use 111 and speak to their GP or pharmacist. Our staff and volunteers continue to work extremely hard to respond to calls and incidents. I would like to take this opportunity to thank them for their hard work and commitment at this challenging time."
Betsi Cadwaladr UHB
Welsh health board Betsi Cadwaladr UHB declared a 'critical incident' on December 19 and has cancelled all but the most urgent procedures in hospitals across the region.
The incident was put in place due to a combination of winter viruses, parents seeking help about strep A, and injuries associated with the cold weather, WalesOnline reports.
Gill Harris, interim chief executive of Betsi Cadwaladr UHB, said that the health board is "struggling to cope with the prolonged, significant demand on the health system in north Wales".
In a statement on Monday she said: "A lack of available beds in our hospitals is currently leading to unprecedented ambulance delays across the health board and we are working closely with local authority colleagues to support medically fit patients to be discharged from hospital. Similar pressures are being experienced in other health boards and English trusts."
Sandwell and West Birmingham NHS Trust
Sandwell and West Birmingham NHS Trust have declared critical incidents at both of its main hospitals - City Hospital in Dudley Road, Birmingham, and Sandwell Hospital.
A senior NHS source told BirminghamLive : "It is really dire - I'm afraid to say that people are dying avoidably because of the current pressures."
A statement from the Trust's staff said they were facing an "extraordinary situation that required immediate action".
They added that amid unprecedented demand at the hospitals "colleagues are working tirelessly to provide the best care possible under these challenging circumstances".
Worcestershire NHS Trust
Worcestershire NHS Trust, which cares for patients at Alexandra Hospital in Redditch, Kidderminster Hospital and Worcestershire Royal Hospital, declared a critical incident yesterday following "several days of sustained and extreme pressure" on their emergency care services.
A spokesperson said: "Supported by our partners in the Worcestershire health and care system, we are taking additional steps to prioritise and maintain safe services for patients.
"Our aim is to prioritise patients with the highest level of need and ensure that we continue to be able to manage emergency care.
"Our teams are continuing to work exceptionally hard, but there are ways that you can help us to help you."
Ambulances are being diverted to other hospitals where possible.
Yorkshire Ambulance Service
Yesterday afternoon the Yorkshire Ambulance Service declared a 'critical incident' due to an 'extremely high volume of calls' having a 'significant impact' on their 999 and 111 operations.
"Our service is under unprecedented pressure and declaring a critical incident means we can focus our resources on those patients most in need and communicates the pressures we are under to our health system partners who can provide support," the service said in a statement.
They added: "While the situation is being managed in line with the plans that we have in place to protect our core services, unfortunately there are patients who are facing delays and we are very sorry that we are unable to respond to them as quickly as we would like.
Other hospitals facing critical incidents include:
Portsmouth Hospitals University NHS Trust
Nottingham and Nottinghamshire's health and care system
South Central Ambulance Service NHS Foundation Trust
Wrightington, Wigan and Leigh NHS Foundation Trust
Derbyshire health and care system
Critical incidents have been declared across all Derbyshire hospitals today (December 21) with pressure on services reaching new levels in the last 24 hours.
The hospitals are facing a number of issues, including difficulties discharging patients and extended patient waiting times, DerbyshireLive reports.
A statement from the hospitals said: "The two general hospitals, Royal Derby Hospital and Chesterfield Royal Hospital, continue to see an increased number of patients arriving at their doors.
"There are also extended waiting times for patients to access beds in these hospitals following arrival in Emergency Departments. There are also difficulties discharging patients due to due lack of capacity across our community care sector."
