NHS bosses have warned hospitals to free up beds to prepare for "extensive disruption" caused by planned ambulance strikes.
Ambulance staff from nine trusts including North West Ambulance Service (NWAS) will walk out on December 21 and 28 in an ongoing dispute over pay. The coordinated walkout by the three main ambulance unions - Unison, Unite and GMB - will affect non-life threatening calls only.
Paramedics, emergency care assistants, call handlers and other staff will strike after voting against the imposed 4% pay award. GMB said the pay award was a "massive real terms pay cut".
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The strike on Wednesday will come the day after planned industrial action from The Royal College of Nursing (RCN) members. NHS bosses have urged hospitals to safely discharge patients where possible to enable staff to hand over patients.
Sir David Sloman, NHS England's chief operating officer, wrote in the letter co-signed by national medical director for England Professor Sir Stephen Powis and chief nursing officer for England Dame Ruth May that plans should be in place by 4pm today Monday, 19 December.
The plans include ensuring all ambulances handover patients no later than 15 minutes and to free up bed capacity by safely discharging patients. The ECHO has covered extensively the significant delays that ambulance crews have been faced with when handing over patients to hospitals.
This was most notably seen in October when a queue of "over 26 ambulances" waited to sign patients over to The Royal Liverpool Hospital because there were not enough beds. Just last week NWAS issued a number of pleas for people to think before calling 999.
The ambulance service warned crews were facing "significant" amounts of calls due to the severe weather and long delays at hospital drop off areas across the region. The ambulance service said crews have been "extremely busy" and hundreds of patients had been left waiting for an ambulance.
Health secretary Steve Barclay called on the unions to ensure "sufficient" emergency cover to protect patients during the strikes. But speaking to the Mirror, Unite boss Sharon Graham said "the unions are not going to blink first".
Rachel Harrison, GMB national secretary, said: "After twelve years of Conservative cuts to the service and their pay packets, NHS staff have had enough. The last thing they want to do is take strike action, but the government has left them with no choice.
"Steve Barclay needs to listen and engage with us about pay. If he can’t talk to us about this most basic workforce issue, what on earth is he Health secretary for? The government could stop this strike in a heartbeat – but they need to wake up and start negotiating on pay."
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