Three ambulance trusts in England have declared critical incidents this week as the NHS struggles to deal with winter pressures and rising demand because of covid-19, norovirus, and influenza.
Making its announcement on 19 December, North East Ambulance Service said it had declared a critical incident as a result of “unprecedented pressure impacting its ability to respond to patients.” It said there had been “significant delays for more than 200 patients” waiting on ambulances, while ambulance crews have been held up because of handover delays at the region’s hospitals.1
Meanwhile, East of England Ambulance Service said it declared an incident after “huge pressure as a consequence of 999 call volumes and hospital handover delays,”2 and South East Coast Ambulance Service said it had experienced “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.”3
Stephen Segasby, chief operating officer at North East Ambulance Service, said, “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 www.111.nhs.uk or speak to their GP or pharmacist.”
The trust said it had been operating at its highest level of operational alert since 5 December.
Last week figures showed that the NHS 111 service received over 700 000 calls from 5 to 11 December, 60% higher than the previous week (rising from 440 047 to 706 129) and the highest number on record (excluding two weeks at the beginning of the covid pandemic). At the same time, covid related hospital admissions rose by 28% and beds occupied by patients with flu rose by almost two thirds, from 712 (28 November to 4 December) to 1162 (5 to 11 December).4
Industrial action
The pressures faced by the ambulance services came as many ambulance workers took part in the first of many planned days of strike action over pay. Members of the unions GMB, Unite, and Unison will be on strike on 21 December, while GMB also has a second day planned for 28 December.
In a statement ahead of the industrial action, North East Ambulance Service said it would not know how many of its 3000 staff would be on strike until the day but said it “expects to see a large proportion of our workforce taking industrial action throughout the region.”5
Segasby said, “Ambulances will still be able to respond during the strike, but this will only be where there is an immediate risk to life. This means that less serious calls will not receive a response for the duration of the strike action and some patients might be asked to make their own way to hospital, where it is safe for them to do so.
“Patients waiting for an ambulance should only call back if your symptoms worsen so that our health advisers are available to take new emergency calls or to cancel an ambulance if alternative transport has been arranged.”
More strike dates in January
Nursing staff have already begun their strike action over pay, with up to 100 000 nurses walking out twice in the past week as part of planned industrial action.6 Like nurses, ambulance workers voted for industrial action after the government awarded most NHS staff a 4.5% pay rise. Unions have said the average NHS earnings had fallen by more than 17% in real terms since 2010.
After the second day of nursing strike action, the Royal College of Nursing said that if the UK government “fails to respond within 48 hours” it will “be forced to announce further strike dates for January 2023.”
The RCN’s general secretary and chief executive, Pat Cullen, said, “[Nursing staff are] prepared to sacrifice a day’s pay to have their concerns heard . . . It is unprecedented for my members to strike. Let’s get this wrapped up by Christmas. I will negotiate with [the prime minister] at any point to stop nursing staff and patients going into the new year facing such uncertainty. But if this government isn’t prepared to do the right thing, we’ll have no choice but to continue in January, and that will be deeply regrettable.”
In Scotland the government tabled a 7.5% pay deal for NHS staff before any strike action had taken place. RCN members are still consulting on this offer, while it has been accepted by Unite, Unison, and the Chartered Society of Physiotherapy and rejected by GMB.
Last week Labour’s shadow health secretary, Wes Streeting, said he believed that the Conservative government had refused to negotiate with the unions so it could blame the NHS’s problems on striking staff rather than “the challenges that have been 12 years in the making.”7