Image source, Reuters
Image caption, Unison members set up a picket line outside the London Ambulance Service HQ in Waterloo, London
By Philippa Roxby
Hospitals were quieter than normal during Wednesday’s ambulance strikes, but Thursday is likely to be “very challenging” with lots of patients turning up, health bosses say.
Only the most serious 999 calls were responded to.
But there was no evidence of people going to A&E in taxis or their own cars, NHS Providers told the BBC.
Thousands of paramedics, call handlers and technicians took action in England and Wales on Wednesday.
Saffron Cordery, interim chief executive of NHS Providers, which represents hospital trusts, mental-health trusts and ambulance services in England, said it was still too early to know the full impact of the strike, but she said category-one calls – which are life-threatening situations – “had been answered”.
And she said she had heard talk of union members “coming off the picket line” to answer those calls.
But she warned of a rebound effect over the coming days as large numbers of people turn to the health service, pushing up demand to levels similar to the day after a bank holiday.
Thursday and Friday were going to be “incredibly difficult days across the NHS because there is a lot of unseen demand and risk out there”, she said.
She said people changed their behaviour on Wednesday, heeding the call not to use services.
“But some will have chosen not to use them at all, even though they need them,” she added.
Image source, PA Media
Image caption, The military were drafted in to fill behind striking staff
Andrew Morgan, chief executive of United Lincolnshire Hospitals said there had probably been more walk-ins on Wednesday.
This can create “more of an issue” because staff do not know people are coming in or what is wrong with them, he said.
Mr Morgan also said Thursday could be a “very difficult day” – predicting that people who thought they should not call an ambulance or should stay away from emergency departments on Wednesday would come in.
A spokesperson for West Midlands Ambulance Service – one of nine where industrial action was taking place in England – said there had been a reduction in calls and staff were grateful to the public for heeding advice to call 999 only in life-threatening situations.
Unions had agreed that ambulance workers would respond to category-one 999 calls and the most serious category-two calls (emergencies, including strokes and major burns) during strikes, but there would be no guarantee of a response to less urgent calls, such as falls.
This prompted Health Secretary Stephen Barclay to accuse unions of taking a conscious decision to inflict harm on patients – an accusation that Unite union leader Sharon Graham said was a “blatant lie”.
“The unions have negotiated critical cover, including 999 calls, at a local level with hosts of NHS trusts. That is how it is done,” she said.
People were also being urged to use their own transport or take a taxi to get to hospital. But Ms Cordery said that “as far as we can tell”, people had not been attending A&E in taxis or by their own vehicles.
What do I do if I’m hurt?
Patients who are seriously ill or injured, or whose lives are in danger, are being advised by the NHS to call 999.
For all other healthcare needs, the NHS is advising people to contact NHS 111 online or via the NHS 111 helpline, or to contact their local GP or pharmacy.
The strikes come at a time when the health service is already under immense pressure.
Lengthy ambulance response times, long delays to hand over patients at A&E departments, and patients not being discharged quickly enough from hospital when they are ready to go home are creating a ‘flow’ problem, experts say.
Ambulance waits for calls classed as emergencies have doubled in two years – from an average of around 20 minutes to more than 40 minutes. The target is 18 minutes.
There are also record-high numbers of people waiting for operations – now seven million in England alone – an issue that has been made much worse by the Covid pandemic.
Ambulance workers in England and Wales are demanding a pay rise above inflation which they say will improve morale and help prevent staff, faced with rising pressures, from leaving their jobs.
Government ministers though say most ambulance staff have received a pay rise of at least 4%, taking average earnings to £47,000. A further pay increase would mean taking money from frontline services, they added.
But unions say that unless the government agrees to meaningful pay talks, industrial action could escalate in the new year.
Ambulance staff from the GMB union are already set to walk out in England and Wales again next week, on 28 December.
And Unison – the largest ambulance union with 30,000 members – plans to re-ballot members in Wales and half the ambulance services in England after the turnout in the original vote narrowly missed the 50% threshold required for industrial action.
Fresh votes have also taken place or are planned by the GMB and Unite unions raising the possibility of further – and more widespread – strikes in the new year.
In Scotland, Unison and Unite previously called off ambulance strike action following pay talks.
The GMB union voted to reject a pay deal from the Scottish government – but it did not strike on Wednesday because it was still considering its next steps, and it says it hopes strike action will not be necessary.
Northern Ireland’s ambulance service held a 24-hour strike on 12 December.