Ambulance services face major disruption on Wednesday as staff go on strike across Wales. Ambulance staff from the GMB Union will walk out across England and Wales on Wednesday, the first of two planned strike days over the Christmas period in a row over pay. A second day of action will take place on Wednesday, December 28.
The strike is expected to have a significant impact on ambulance services on Wednesday. Welsh Ambulance Service has said people should only call 999 if they are seriously ill or injured and there is a risk to life, such as cardiac arrest, continuous fits, lack of consciousness or breathing difficulties, and some cases of acute behavioural disturbance.
Non-urgent calls are unlikely to receive an emergency response and life-threatening calls are expected to see major delays. In some cases, staff will be asking patients to make their own way to hospital. Category 'red' calls - those which are deemed the most serious - account for around 15% of all calls made to the ambulance services in Wales.
Wednesday's stoppage includes Welsh ambulance staff across departments including paramedics, frontline workers, ambulance care assistants, some control room staff and corporate staff. Although the strike lasts for 24 hours, there is likely to be a knock-on impact meaning services will be disrupted from late Tuesday night into Wednesday morning, and from late Wednesday into the following day.
Read more: The Welsh ambulance workers strike: How you might be affected and everything you need to know
The strike comes on the back of unionised staff from the Royal College of Nursing (RCN) - which also includes some ambulance staff - staging their second day of strike action on Tuesday December 20, over pay after an initial strike on December 15. Health services in Wales are already under severe strain and Wednesday's strike is likely to heap further pressure on already stretched hospitals and medical services.
NHS experts this week described demand on the health and care system as "relentlessly high" while call volumes to the NHS Wales 111 helpline have increased by a whopping 300% - the highest on record. Betsi Cadwaladr University Health Board this week declared a "critical incident" due to unprecedented demand and cancelled all but the most urgent procedures. Wales is currently battling higher cases of scarlet fever and strep A as well as rising Covid rates which have seen the number of people needing treatment treble in three weeks. Here is everything you need to know about Wednesday's strike including which patients will receive a response during the action.
Welsh health minister Eluned Morgan said the strike would cause "huge pressure" on ambulance services after nurses' strikes caused a delay in treatment for thousands of patients and asked people to carefully consider what activities they took part in on Wednesday and on December 28 in order to avoid putting further pressure on services.
"There’s no doubt the two days of industrial action, following hard on the heels of action by nurses which have caused a delay in treatment for thousands of patients in Wales, are going to cause huge pressure on ambulance services," she said. "Ambulances will only be able to respond to the most urgent calls on strike days.
“Please don’t add extra pressure on services on these days and consider carefully what activities you take part in tomorrow and on December 28. It’s important to call 999 if in you are in immediate danger, but we must all consider very carefully how we use ambulance services on these days. It’s vital that all of us, as users of our NHS, do all we can to minimise pressure on our health service during the industrial action."
Why are ambulance staff going on strike?
In Wales, members of the GMB Union are striking in protest at the Welsh Government's pay offer of a £1,400 pay increase to most NHS staff - equivalent to a 7.5% increase for lower-paid staff in Bands 1 to 4 and a 4% increase in Bands 6-7. Some employees say this is not enough when compared to the current inflation rate of around 10.6% but no further offers have been put on the table. The Welsh Government claims it cannot address the pay issue without extra help from the UK government.
Who will be able to get an ambulance during the strike?
Under the strike conditions, the Welsh Ambulance Service - and all other striking ambulance services in the UK - have agreed a list of 'derogations', or exemptions, with union officials. This is in order to ensure staff can still respond to calls in certain situations where there is a threat to life.
Under the agreement the following are exempt from the strike on Wednesday:
- Emergency medical services (EMS) call handlers, dispatchers and allocators
- EMS emergency ambulance crews and Cymru high acuity response units (CHARU) to respond to all ‘red’ calls and a sub-set of ‘Amber 1s’
- Hazardous area response team (HART)
- Clinical support desk
- Non-emergency patient transport services (NEPTS) for renal dialysis, oncology, humanitarian and out-of-Wales transfer for urgent/emergency treatment.
- Grange University Hospital discharge and transfer service including critical care transfers
- Make Ready Depot to maintain vehicle restocking and on-the-day vehicle decontamination
- Major incidents
These exemptions mean the Welsh Ambulance Service can respond to all ‘red’ calls - those categorised as immediately life-threatening, including cardiac arrest, continuous fits, lack of consciousness or breathing difficulties and some cases of acute behavioural disturbance. Selected ‘Amber 1’ calls for particular complaints including chest pains, stroke and gynaecology emergencies may also receive a response. ‘Amber 1’ calls may also be responded to after a remote clinical assessment, dependent on the outcome.
Any transport for outpatient journeys that do not fall under derogations will be cancelled and the service's team is contacting all patients booked for December 21 and 28 to arrange alternative transport. Otherwise, patients will be advised to contact their healthcare provider to rearrange their appointment if required.
Health minister Eluned Morgan has confirmed military personnel will be used for logistics on strike days, but, unlike in England, the army has not been drafted in to drive ambulances in Wales.
What if I need an ambulance?
The Welsh Ambulance Service has said patients should only call 999 on Wednesday, December 21, if seriously ill or injured and there is a risk to life. Ambulances will still be able to respond in these situations, but it is likely that only these life-threatening illnesses or injuries will receive an emergency response on the day. Some patients might be asked to make an alternative arrangement such as making their own way to hospital.
The service is asking people to consider alternatives to 999 like your GP, pharmacist, the NHS 111 Wales website or Minor Injuries Unit and to stock up on prescription medications and over the counter remedies to reduce the risk of you falling ill on strike days. It is also asking people to take extra care during the cold spell to avoid slips, trips and falls and accidents on the road.
For other medical issues, people should attend their own GP during normal opening hours or use the NHS 111 Wales website for medical advice.
How will staff who aren't striking decide what is 'life threatening'?
On strike days, the staff who are working will screen each call in the usual way to assess its level of severity. Non-clinical call handlers will answer the call in the normal way, triage the call using the algorithm employed by the ambulance service which will categorise the call based on the information given over the phone. People calling the NHS helpline on 111 are being warned of delays as the service is likely to be extremely busy as many call handlers and clinicians will be on strike. Anyone seriously ill, injured or whose life is at risk should seek emergency care in the normal way by calling 999 or attending A&E.
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