NHS England set out advice for the public on 20 December 2022, ahead of industrial action by ambulance workers at nine out of 10 ambulance trusts the following day1. The same statement said nurses were striking in 44 NHS trusts across England on 20 December1.
The NHS asked patients to use services wisely during the action. It said people should use NHS 111 online as the first port of call for health needs and continue to call 999 only for a life-threatening emergency1. It said patients should still call 999 where anyone requires life-saving care, with ambulance services prioritising the most clinically urgent cases, and that if a condition is not life-threatening people may have to wait longer than usual for an ambulance1. Where it is safe and appropriate, patients may be asked to make their own way to hospital, but the NHS said it is important that they get medical advice from 111 or 999 before doing so1. In all cases, priority will be given to those with the most clinically urgent health needs1.
General practice, community pharmacies and dentistry were not affected by the strike action, according to the statement1. The NHS said it would contact anyone whose appointment had to be rescheduled, and that patients not contacted should attend appointments as planned1. It also asked the public to take simple steps to look after themselves and others, such as drinking responsibly or stocking up on medication, and checking in on vulnerable family members and neighbours1.
NHS Medical Director Professor Sir Stephen Powis said:
"There is no doubt that the NHS is facing extreme pressure and industrial action will add to the already record demand we are seeing on urgent and emergency care, and so it is really important that the public play their part by using services wisely."
The statement said October and November 2022 were the busiest on record for A&E attendances and the most serious ambulance callouts1. It said more than 6.5 million people used NHS 111 online in the last 12 months, with an average of 20,000 users a day being directed to the right support1. After entering answers about health needs online, the service makes an assessment and directs people to the best place for their care, which can include a consultation with a pharmacist, a call back from a nurse, or visiting a same day urgent treatment centre or A&E1.
Why it matters for households
The disruption was expected on 21 December 2022, the day after the nurses' strike, and covered nine out of 10 ambulance trusts1. For households, the practical effect described by the NHS is longer waits for an ambulance where a condition is not life-threatening, and the possibility of being asked to travel to hospital themselves after getting advice from 111 or 9991. The NHS said life-saving care should still be sought through 999, with the most clinically urgent cases prioritised1. GP appointments, community pharmacies and dentistry were reported as unaffected1. The NHS asked people to check on vulnerable family members and neighbours and to keep themselves safe so as not to end up in A&E1. The statement did not name the individual trusts affected or the unions involved; those details have not been reported here. Households wanting to follow official warnings and service updates can use the staying informed hub.
What happens next
The NHS said it had plans in place to manage additional demand, including 24/7 control centres, additional bed capacity, more mental health support for ambulance services and more community falls services1. It said regional and national teams would support local areas needing further assistance on strike days1. Guidance issued ahead of the action asked local systems to discharge patients who are medically fit and asked that local areas only cancel elective procedures as a last resort1. NHS England also said it had issued guidance to local NHS employers on the derogations they should seek from local union representatives to ensure certain vital services such as chemotherapy continue1. No further strike dates were given in the statement.
