As many hospital beds as possible in England should be freed up ahead of “extensive disruption” caused by ambulance staff strikes, NHS bosses have said.
Ambulance staff in England and Wales are expected to walk out on 21 and 28 December in a dispute over pay, prompting fears about bed capacity across the service. Members of the Unison, Unite and GMB unions are expected to take part.
In a letter to staff on Friday, David Sloman, NHS England’s chief operating officer, Stephen Powis, the national medical director, and Ruth May, the chief nursing officer, said it would be a “very challenging period”.
They called for patients who have completed their emergency medical care to be moved out of emergency departments to create space for new patients.
The letter read: “Take steps to allow moving of patients who have completed their emergency medical care and are awaiting an inpatient bed out of the [emergency departments] to create space for new patients.
“This may involve the creation of observation areas and additional beds elsewhere in the hospital.”
It said rescheduling urgent cancer treatment should only be considered if all other options have been exhausted and every effort should be made to maintain appointments.
It also said measures should be put in place to ensure ambulance patient handovers are kept to no more than 15 minutes.
However, the president of the Royal College of Emergency Medicine, Adrian Boyle, said discharging patients from hospitals where possible ahead of NHS strikes would be challenging.
“It’s going to be really difficult to achieve,” he told the BBC’s Today programme. “We always want to be able to allow ambulances to return back to the frontline as quickly as possible. We’ve been struggling to do this for the past three years.
“To give you an idea of how big the problem is, in the last week, three-quarters of emergency departments are holding ambulances with handover delays every day. And this is because our emergency departments are full.”
NHS data shows that one in six patients last week waited more than an hour to be passed to A&E teams after arriving in an ambulance. Just over one in three had to wait at least 30 minutes.
Oliver Dowden, the chancellor of the Duchy of Lancaster, said the ambulance workers’ strike would cause “significant impacts and significant disruption”.
He told the Daily Telegraph: “Of course, the government is working hard to ensure that that is minimised. But you can’t call a strike in this area and think that it’s not going to have an impact. And it will have an impact.”
Asked if lives are at risk, he said: “I don’t think it’s helpful to engage in speculation,” but added: “There is significant risk associated.
“But the government is not going to be able to mitigate away all of the impacts of these strikes. And particularly with something like the ambulance strike, we cannot remove those risks. Those are big risks that people face.”
The ambulance workers strike comes amid warnings that NHS nurses could strike for longer, at more places and will disrupt more NHS services from next month unless the government increases its pay offer.
Tens of thousands of outpatient appointments and non-urgent operations were cancelled on Thursday as nurses went on strike over pay. A second 12-hour stoppage is due next Tuesday. Rishi Sunak is refusing to bow to pressure from health leaders and senior Conservatives, including the former health minister Dan Poulter and former cabinet ministers Jake Berry and Robert Buckland, to negotiate pay with nurses to prevent further action.
The general secretary of the RCN, Pat Cullen urged the prime minister to step in and get a grip before the situation “engulfs the NHS”.
“The resolve these nurses have is strong and in January it will be an escalation,” she said. “It will involve a longer period of time and significantly more organisations.”
Sunak insisted on Friday that the offer given to nurses was “appropriate and fair”.
