London Ambulance Service moved to Resource Escalation Plan 4 (REAP 4), its highest level of escalation, on 19 December 2024, as festive demand pushed the service beyond its usual winter levels. The service said the level indicates "extreme pressure" on its operations1.
The service reported that 999 calls for all emergencies were up around six per cent on Thursday, Friday and Saturday nights this month compared with the same period in spring. Over the past few weeks it recorded a rise in alcohol-related incidents at the end of the week of up to 38 per cent. It said it had recently taken more than 7,000 calls in one day, a level usually seen only on New Year's Eve, and that it was handling around 600 alcohol-related incidents every week1.
Darren Farmer, Director of Ambulance Services, said:
"However, in the past few weeks, we have seen a rise in alcohol-related incidents at the end of the week of up to 38 per cent which clearly shows the impact Christmas celebrations are having on our services."
Chief Paramedic Pauline Cranmer said alcohol-related incidents include people passing out, injuring themselves and becoming violently unwell, and that patients who have collapsed or are unconscious because of alcohol usually get a priority response, which can leave other critically ill patients waiting for an ambulance1. The service said demand on the evening of Thursday 19 December was expected to be particularly high as people celebrated ahead of the Christmas getaway, which the AA said would start on Friday1.
Why it matters for households
The escalation applies to ambulance response across London, and the service said the pressure affects how quickly crews reach patients, with priority given to those who are unconscious or collapsed from alcohol1. Its public message, to be carried on the Transport for London network, asks people going out to dress for the weather, eat before drinking alcohol and plan their journey home before drinking, and to use 999 only in serious medical emergencies1. Chief Paramedic Pauline Cranmer said: "Our message to Londoners is to have a good time, but drink responsibly"1. The service has not reported any change to what households should do if they need an ambulance beyond calling 999 in serious medical emergencies. General guidance on following official alerts and updates is set out in the guide to staying informed.
What happens next
The service has not reported when REAP 4 will be stood down. It said further increases in alcohol-related calls were expected over the Christmas and New Year period1.
