NHS leaders have voiced alarm after a leading health union unveiled plans for 10 more strikes that will severely disrupt ambulance services over the next two months.
The Unite union’s move means the NHS will face an even greater struggle to provide normal care on 6 February, when nurses and ambulance personnel in the GMB union are already set to walk out.
Unite said that the major escalation of its pay dispute had been prompted by ministers wrongly claiming that ambulance workers are refusing to guarantee patients’ safety on strike days.
Meanwhile, GPs have been warned that they could be prosecuted or disciplined if they act as a “Good Samaritan” by driving a patient to A&E who cannot get an ambulance, but been advised to do so anyway in order to save lives.
Unite’s members who work in ambulance services in the north-west, north-east and east and west Midlands of England, Wales and Northern Ireland will stage varying numbers of stoppages up to 10 times on seven different days between 6 February and 20 March.
GMB members who are paramedics, call handlers or perform other roles in the ambulance service are already due to strike on many of the same days. In addition ambulance members of Unison, the largest NHS union, will hold their latest stoppage on Monday 23 January.
“Ten more days of strikes by Unite ambulance staff will make what is already an incredibly difficult situation for NHS patients and staff even harder,” said Miriam Deakin, the director of policy at NHS Providers, which represents health service trusts in England.
“As one of these dates, 6 February, coincides with strikes by nurses and GMB ambulance workers next month, trust leaders are facing what for many may be the most challenging day of their careers.
“Escalating industrial action will only cause further disruption and impact patient care at a time when trust leaders and their staff want to focus on driving down waiting times.”
The two ambulance strikes so far this winter in England have forced hospitals to postpone 10,000 operations and more than 50,000 outpatient appointments.
Sharon Graham, Unite’s general secretary, rounded on ministers, including the health secretary, Steve Barclay, and the transport secretary, Grant Shapps, for accusing ambulance personnel of not guaranteeing to respond to the most urgent 999 calls on strike days.
Ministers have made that claim even though in the first two ambulance strikes, held last month and last week, the unions involved have agree to answer all “category one” calls – which involve life-threatening emergencies – and also “category two” calls, such as heart attacks and strokes.
“Rather than act to protect the NHS and negotiate an end to the dispute, the government has disgracefully chosen to demonise ambulance workers. Ministers are deliberately misleading the public about the life and limb cover and who is to blame for excessive deaths,” said Graham.
Meanwhile, GP Survival, a campaign network of 10,000 family doctors, has advised GPs to put patients’ welfare above the risk of facing consequences if they take patients to A&E.
The group has drawn up advice to guide GPs about what to do if they are faced with a seriously ill patient who cannot get an ambulance to come quickly after a 999 call.
It has done so amid a small but growing number of reports that family doctors have felt obliged to drive a patient to A&E in desperation because no ambulance was available.
GPs face various risks if they do so, such as potential prosecution for breaking the speed limit or driving without the correct insurance if they have an unwell patient on board, being referred to the General Medical Council (GMC), the medical regulator, or having to account for their actions at a coroner’s inquest.
Dr John Hughes, the chair of GP Survival, said that its advice is that, when no ambulance is available, a GP should risk-assess, and then clinically assess, the patient’s condition – and be ready to drive patients to hospital, regardless of the risks involved, to potentially save lives.
As an alternative to GPs taking the patient, “if the risk of patient harm or death is significant in the face of delayed ambulance response, [GPs should] advise caller to raise neighbours to help transfer the patient to the nearest emergency department”, its 12 recommendations say.
The advice states that, because GPs are not an emergency NHS service, “we would ask that in the event of adverse outcomes in such scenarios, [the] GMC and coroners have regard to this fact and treat GPs involved as acting in extremis as a Good Samaritan capacity in the best interests of their patient, rather than recklessly and unprofessionally acting outwith their capacity and training.”
Hughes accused NHS England of a “dereliction of duty” for not having already put together its own official advice for GPs on such situations, given they are occurring more regularly.
NHS England said it had advised GPs how to handle their caseload on ambulance strike days, and that NHS 111 and 999 call handlers were best placed to decide whether patients should make their own way to hospital.
An NHS spokesperson said: “Ahead of and during the ambulance strikes, we have provided information to the public, GPs and other healthcare professionals on the impact of industrial action while also advising them to use 111 online and continuing to call 999 in a life-threatening emergency.
“Ambulances will still be able to respond where there is an immediate risk to life, so callers should take advice from 111/999 call handlers on whether there are circumstances where it is suitable for them to make their own way to hospital.”
Wes Streeting, the shadow health secretary, told the Guardian the next Labour government would review the public pay review bodies which set the salaries for millions of workers.
“Clearly it’s not working. There are genuine concerns in the trade union movement that the body itself isn’t independent enough from government.”
