Health chiefs have warned that they cannot guarantee patient safety as ambulance workers prepare to walkout on Wednesday against the backdrop of a surge in “critical incidents” across the NHS.
The NHS Confederation and NHS Providers, bodies that represent health organisations across England and Wales, have written to Rishi Sunak, the prime minister, to warn of the risk to patients, and to urge him to reopen pay negotiations to forestall further action.
Sunak and Steve Barclay, the health secretary, have refused discussions after accepting the recommendations of the independent pay review body this year. Health workers were awarded an average rise of about 4 per cent.
The Unison, GMB and Unite trade unions are calling for increases in pay to match inflation, with more than 10,000 ambulance workers expected to go on strike this week.
The fresh wave of industrial action comes as thousands of nurses, represented by the Royal College of Nursing, held the second of two planned 12-hour strikes across England, Wales and Northern Ireland on Tuesday.
Matthew Taylor, chief executive of the NHS Confederation, told the BBC’s World at One: “We never want to alarm people but we have reached the stage where our leaders feel it’s necessary to say that they cannot guarantee patient safety, they cannot avoid risks as these strikes unfold.”
Taylor suggested that pragmatism on both sides was needed in the face of the huge challenges facing the NHS. He said that if the government was not willing to negotiate “then industrial action will take place”, adding: “If industrial action takes place, then there will be risk, there will be harm to patients.”
Earlier on Tuesday Will Quince, a health minister, urged the public to avoid “any risky activity” during the ambulance staff walkouts in England and Wales on Wednesday.
He spoke as several ambulance trusts around the country declared “critical incidents”, a status invoked when services are at risk of being overwhelmed.
The London Ambulance Service said it was “prioritising our sickest and most severely injured patients”, while the North East Ambulance Service said more than 200 people had faced “significant delays” in ambulances arriving.
Meanwhile, the South East Coast Ambulance Service highlighted “a period of more than a week of sustained pressure across both our 999 and 111 services, which has significantly impacted on our ability to respond to patients”.
Barclay met the ambulance unions on Tuesday, when he was expected to urge workers to honour their commitment to respond to life-threatening emergency calls, amid warnings that those with urgent conditions will have to make their own way to hospital.
Sara Gorton, Unison head of health, said that unions had agreed with ambulance trusts to provide cover for patients at severe risk. These agreements included “fail-safe positions” in the event of “major incidents like attacks or multiple pileups”.
She warned that the strikes could be stepped up if ministers did not agree to discussions, pointing out that Unison had limited its action on Wednesday to 12 hours and only called out road crew, rather than call handlers, for example.
“We really, really hope tomorrow’s action could be called off with a commitment to boost pay and hold serious and genuine talks with unions but if tomorrow goes ahead it looks likely there will be further escalation in the new year,” she added.
Speaking on Tuesday at the health and social care select committee, Julian Redhead, national clinical director for urgent and emergency care at NHS England, argued that even before strike action had begun, demand on emergency services had increased by “phenomenal degrees”.
But Rachel Harrison, GMB’s national secretary, defended the timing of ambulance worker walkouts, arguing that staff were experiencing “stress, burnout, exhaustion”. She accused the government of “hiding” behind the independent pay body’s recommendations that more than one million NHS workers receive a £1,400 salary increase.
“What we’re calling on the government to do is talk to us, make us an offer that we can take to our members because our members don’t want to strike,” she added. “They’ve been forced into this.”
