Fallout from strike disruption likely to last into coming days – health leaders

NHS Providers said there had been ‘varying levels of disruption’ across the country as nurses and ambulance workers went on strike this week.

21 December 2022

Disruption to care following strikes this week is likely to spill over into the coming days, health leaders have warned.

People whose conditions might have worsened because they delayed seeking help were a particular concern, the membership organisation for NHS hospital, mental health, community and ambulance services said.

NHS Providers also warned about the knock-on impact to appointments which needed to be rescheduled and said they anticipated a return to “very high numbers” of emergency calls.

The number of people phoning 999 appeared to have dropped in some parts of England on Wednesday as thousands of ambulance staff and paramedics went on strike until midnight.

NHS Providers said there had been “varying levels of disruption” across the country, with some demand shifting to other services or not materialising as expected.

But the organisation added that demand for care across the whole healthcare system remained high and that trust leaders were reporting ongoing delays to ambulance services and overcrowding at some accident and emergency departments.

Some ambulance trusts reported receiving fewer calls during the day, with the West Midlands Ambulance Trust thanking people for heeding their advice to only call in an emergency.

NHS Providers said it had reports of trust leaders and staff feeling “a sense of helplessness and moral injury” at not being able to provide the appropriate help in a week which saw nurses and ambulance workers go on strike.

But the organisation said trust leaders “of course understand” the strong feelings of nurses and ambulance staff, and appealed for “urgent, serious talks – including on pay” between the Government and unions in a bid to avert further industrial action.

Saffron Cordery, interim chief executive of NHS Providers, said: “Leaders across the NHS also know that as this week’s strike action draws to a close, the disruption is far from over.

“The fallout from strike action is likely to spill over into the coming days due to the knock-on impact across different parts of the health and care system, the need to reschedule elective and outpatient appointments, and the anticipation of a return to very high numbers of emergency calls.

“There is particular concern about patients who may have delayed seeking care – and whose conditions have deteriorated – now coming forward for treatment.”

Health leaders urged people to still call for an ambulance if they were experiencing a life-threatening emergency, amid fears that even those who needed help would not call.

Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told the PA news agency: “There may be a number of reasons why 999 calls are dropping – hesitancy may be a key factor during the industrial action.

“We want to reassure patients and the public that if they need emergency care, A&Es remain open.”

A West Midlands Ambulance Service spokesman told PA it had been experiencing fewer calls than normal.

There, the GMB and Unite unions had agreed to respond to category 1 and serious category 2 calls.

The Welsh Ambulance Service told PA “demand is manageable” but warned that “any influx of calls would put significant pressure on our service”.

Meanwhile, the East Midlands Ambulance Service said on Wednesday afternoon that it was too early to say how the service was coping.

Its advice to the public remained to only call 999 if there was a risk to life or if somebody was seriously ill or injured.

Up to half of its more than 4,000 workforce were GMB members who were striking.

The trust said it had agreed exemptions with the union for staff to either attend category 1 calls or category 1 calls and the most serious category 2 calls such as chest pain, strokes, gynaecology emergencies where mother or baby are at risk, road traffic collisions where a patient is trapped, and unwell children aged five and under.

South Central Ambulance Service told PA its main impact from strikes was patient transport services in Sussex and Surrey, rather than urgent and emergency care services.

The London Ambulance Service declined to comment on how services were running.

Earlier on Wednesday, there was a bitter war of words between unions and Health Secretary Steve Barclay, who has said he will not back down on pay.

Mr Barclay said the Unite, Unison and GMB unions had “refused” to work with the Government at the national level to set out plans for dealing with the strikes. But the unions said all those agreements had been made locally and were in place.

Unite general secretary Sharon Graham also accused Mr Barclay of a “blatant lie” for saying ambulance unions had taken a “conscious decision” to inflict harm on patients.

Earlier, Mr Barclay said there was a need to “look forward” to next year’s pay process after he declined to review the current offer.

A paramedic based in Nottinghamshire told PA that patients’ lives had been at risk for a long time due to issues in the NHS.

Tom, 33, from the East Midlands Ambulance Service, said: “I’ve attended elderly patients who have been on the floor with broken hips for over 20 hours.

“They’ve been waiting that long that their limbs have started to become necrotic (dying tissue), resulting in major surgery to remove said limbs.”

He said that at one point, 11 ambulances were stuck at hospital waiting to hand over patients to A&E.

“The conditions we work in on a regular basis don’t enable us to do the job we want to do to its full capacity and is putting patients’ lives at risk long before strikes were even considered,” he said.

The majority of ambulance trusts in England are on their highest level of alert, meaning they cannot provide usual critical services and patients may be harmed.