Ambulance strikes UK: what plans are in place? Government advice for emergencies and when to call 999

The government said its priority is to protect the public who may need access to emergency services

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Ambulance workers are striking on 21 December over pay and staffing issues. But what plans are in place for these strikes and how will it work? Here’s what you need to know.

UNISON, Unite and the GMB have confirmed that members will take part in strike action on Wednesday 21 December 2022. GMB members will also take part in an additional strike day on Wednesday 28 December.

Strikes on these dates will mainly impact NHS ambulance services. GMB members will strike in nine ambulance trusts, UNISON members will strike in five ambulance trusts and Unite members will strike in three ambulance trusts. UNISON also has a mandate for industrial action at Liverpool Heart and Chest Hospital NHS Foundation Trust and Liverpool University Hospitals NHS Foundation Trust, where strikes will also take place on 21 December.

Why are ambulance workers striking?

Ambulance workers from the three unions are striking over a demand for a bigger pay increase than that decided earlier this year by the NHS pay review body. Health Secretary Steve Barclay and other ministers have said they are unwilling to go beyond the offer already made, which gives an average increase of 4.75% and a guaranteed minimum rise of £1,400 a year.

Nurses from the Royal College of Nursing union will also take part in the second of two planned strikes on 20 December.

Ambulance workers are set to strike over pay and staffing issuesAmbulance workers are set to strike over pay and staffing issues
Ambulance workers are set to strike over pay and staffing issues

Which 999 calls will be prioritised?

The public have been warned to avoid “risky activities” during strike action. Health minister Will Quince urged people to stay safe on Wednesday, telling BBC Breakfast: “Where people are planning any risky activity, I would strongly encourage them not to do so because there will be disruption on the day.”

The health minister did not offer examples of what might be defined as risky behaviour but told the public that in any emergency calling 999 should still be the first option.

He said the “key thing” is that for anybody that does have an emergency situation or a life-threatening situation “they continue to call 999 as they would have done previously, and for any other situation, NHS 111 or NHS 111 online”.

Later on BBC Radio 4, he also said that anyone with chest pains on Wednesday should still call 999. Negotiations between unions and ambulance services are ongoing to work out which incidents should be exempt from strike action.

It is expected that all category 1 calls, the most life-threatening such as cardiac arrest, will be responded to. Some ambulance trusts have agreed exemptions with unions for specific incidents within so-called category 2 which covers serious conditions, such as stroke or chest pain.

What plans are in place for ambulance strikes?

The Department for Health and Social Care (DHSC) said the priority during strikes is to keep patients safe. NHS England will work with providers, professional bodies and trade unions to agree the safe level of cover during any industrial action.

Hospitals will also do everything they can to proceed with planned procedures during periods of industrial action, especially for patients with the greatest clinical need. The DHSC said the NHS has tried and tested plans in place to mitigate risks to patient safety and manage disruption, and are working with them closely.

Hospitals will do everything they can to ensure patients and the public are kept safe and emergency and urgent treatments will be prioritised during strike action. NHS England has said the default approach is that appointments and operations should continue unless there is a clear patient safety reason to reschedule. Nobody should be put off seeking urgent or emergency care during strike days, with key 999 services to continue to operate.

The government said its priority is to protect the public who may need access to emergency services at a time when the cold weather and Covid’s impact has put NHS services under huge pressure.

Arrangements have been made to deploy 1,200 Armed Forces to backfill roles such as ambulance driving and border checks. These include 600 drivers and a further 150 personnel providing logistical support direct to members of the armed forces driving ambulances. Community First Responders will also be utilised to help manage demand for medical care.

However, during the strike, the military will not drive ambulances on blue lights for the most serious calls but are expected to provide support on other calls. Mr Quince said that armed forces personnel would play a key role but would not be able to “break the law” when covering for ambulance workers.

What has the Health Secretary said?

Health and Social Care Secretary, Steve Barclay, said NHS staff “do an incredible job”, but that it is “deeply regrettable” some union members are going ahead with further strike action.

He added: “My number one priority is to keep patients as safe as possible and we are stepping up preparations across government and the NHS, including making best use of the armed forces, volunteers and freeing up capacity to mitigate disruption and ensure safe staffing levels. People who need emergency and life-threatening care should continue to come forward as normal, or use NHS 111 online for urgent advice.

“I have listened to unions and am open to further discussions, but their demands are not affordable in the economic circumstances. We have accepted the recommendations of the independent NHS Pay Review Body in full to give staff a pay rise of at least £1,400 – on top of a 3% pay rise last year when wider public sector pay was frozen. Further increases would mean taking money away from frontline services at a time when we are tackling record waiting lists as a result of the pandemic.”