Disruption from strikes likely to continue into coming days – health leaders

Disruption to care after 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 are a particular concern, the membership organisation for NHS hospital, mental health, community and ambulance services said.

NHS Providers also warned about the knock-on effect on appointments that need to be rescheduled and said they expected 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 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 West Midlands Ambulance Trust thanking people for heeding 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 help in a week that 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 had 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 had fewer calls than normal.

The GMB and Unite unions in the region 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”.

The trust later said the “challenge has been growing throughout the day” and “we are trying our best to get to patients who need us”.

Yorkshire Ambulance Service NHS Trust said the day had been less busy than expected and it had been “coping”, although patients have had to wait longer for an ambulance.

East Midlands Ambulance Service 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.

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

Matthew Taylor from the NHS Confederation said “the picture has been mixed across the country” as some ambulance services continue to experience “significant delays in handing over patients to hospital”.

He said this was a “longstanding issue”, adding: “Today, the NHS has pulled out all the stops to ensure that urgent and lifesaving care were prioritised, but it is simply not sustainable to undertake these efforts every day.

“No health leader wanted to be in this situation in the first place and the strikes could have been avoided had the Government attempted to genuinely engage with trade unions about pay.”

NHS England said at least 11,509 staff were absent from work across the country as a result of industrial action by the Royal College of Nursing (RCN) on Tuesday, while 13,797 appointments and procedures were cancelled and rescheduled.

Earlier on Wednesday, there was a 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 a 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 accused Mr Barclay of a “blatant lie” for saying ambulance unions had taken a “conscious decision” to inflict harm on patients, while the GMB called on the Cabinet to “grow up and get round the table” instead of attempting to “smear” ambulance workers.

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.

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.