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Ambulance strikes will create a “very difficult day” for the health service, NHS England’s national medical director has warned. Professor Sir Stephen Powis told BBC Radio 4’s Today programme:
Obviously, today will be a very difficult day with the health service. But we have been working very closely with the unions to ensure that emergency services are maintained for life-threatening conditions, and that will include strokes and heart attacks.
There are more doctors in call centers to ensure that the right response goes out to the right incident.
He said strokes fall at the higher end of category two cases, so doctors will determine what response is needed, and advised people to dial 999 “as usual” if you have a life-threatening condition .
Updated at 09.10 GMT
Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said the emergency system had been under “immense pressure” over the past three years, including “the worst we’ve ever seen” in the last year in terms of delays in delivering patients to A&E. He told Times Radio:
Trying to calculate the effect of industrial action against a system that is no longer doing what we want it to do will be difficult.
He said A&E departments expected people to turn up in different ways during the ambulance strike, adding:
We expect people with strokes and heart attacks to show up at the front door. Now, because of the delays, this has already happened quite a bit anyway.
It’s the best alternative to calling an ambulance – if you think you can get to the hospital in a way that looks safe and effective, with someone to lift you up, it might be more appropriate.
He added that “hospitals are full to bursting” and some people will be waiting a long time in A&E. The UK had the “lowest number of beds of almost any European country” and this was compounded by problems getting people into social care, he said.
Barclay is also doubling down on offering media pressure as justification for not overturning recommendations on NHS pay to deliver more. He told BBC Breakfast that the government had accepted the recommendations “in their entirety”, adding:
Indeed, where in the past the government has not always fully accepted the recommendations, in programs such as this, ministers have been criticized for not doing so.
He agreed that ministers do not have to accept the recommendations of pay review bodies. BBC Radio 4’s Today program was told several examples of different government approaches, including paying for health.
When we do not fully accept the recommendations we are criticized for doing so. On this occasion, we have accepted them in full.
Speaking on BBC Radio 4’s Today programme, Barclay is doubling down on his refusal to negotiate pay and told struggling staff now they should “wait” for next year’s pay process.
We are three quarters of the way through this year. So what you would be saying is that you are going back to April to dismiss what has been an independent decision by the pay review body.
But now we are well underway in terms of next year’s salary revision process, the referral letters are out.
Obviously, that body will then consider changes in inflation, the other issues that have been raised, all as part of the normal process of looking at next year’s pay, so we have to look ahead.
Last week, when nurses went on strike, the former chairman of the NHS pay review body, Jerry Cope, said the pay recommendation was out of date. He told BBC Radio 4’s Today programme:
It took place in February and the world was quite a different place in February and so I think some of the evidence they considered was probably out of date when it was published. Since the process is very slow, the decision is a bit delayed.
Cope also said that this factor offered a possible solution to the government.
I think [ministers] i should ask the pay review body to reconsider what they did last year and not reopen last year because i think it’s too late to do that but i actually want you to make a change very quick to the recommendations this year and I want you to take into account anything you might have missed last time.
He said this could pave the way for a higher offer, in a way that “respects the integrity of the pay review body”, although he also accepted that the pay review could decide not to change its recommendation
Barclay denies escalating the dispute accusing unions of making a “conscious choice” to “inflict harm” to patients.
Asked on BBC Breakfast if his language in the Daily Telegraph was “adding to this current atmosphere”, he said:
No, it reflects the very different action we have seen from these unions – the GMB, Unite and Unison – compared to what we saw from the Royal College of Nursing (RCN), where we agreed national exemptions on what would be covered by the RCN, while the three unions on strike today have refused to work with us nationally.
On Tuesday, MPs heard that unions and ambulance trusts in most parts of England and Wales have reached agreements to ensure “life and limb cover” during the strike. Rachel Harrison, the national secretary of the GMB, told Parliament’s health and social care select committee:
Life and limb coverage will be provided. The last thing our members want to do is put patients at risk… The government needs to play their part, they need to come to the table and talk to us. Our members want a solution to this.
Unions say Barclay has refused to engage substantially with their concerns, telling them it will not budge from the real-terms pay cut it is offering.
And, as NHS bodies call on the government and unions to work constructively to reach a deal in the interests of patients, Barclay is doubling down on comments he made to the Telegraph (see: 7.33am).
They asked him: “This is not conciliatory language, this will not bring the two sides together, this will only harden the side against you, will it not?” The health secretary replied:
Well, it’s just a reflection on the fact that the unions have chosen this time to strike.
Barclay said recent increases in calls to 111 and 999 as a result of flu, Covid and Strep A meant the system was currently under severe pressure.
Ambulance delays were already at their worst levels on record before the strikes, with paramedics and doctors having to work at full speed just to get patients to hospitals.
Many face long waits to be transferred or told to make their own way to hospital, with the NHS blaming a lack of capacity caused by difficulties in discharging patients to community or social care.
In Scotland, the government has already offered 7.5%, a rate that still represents a pay cut in real terms, but which unions have hinted would at least be enough to put their members through.
Asked if he would do the same, Barclay claimed there were “misconceptions” about the deal, telling Sky News its cost is “much more significant” than the nominal 7.5%.
One of the big misconceptions about the deal in Scotland… it wasn’t just 7.5%. If you add in all the other measures to reduce hours, extra annual leave, changes to the way overtime is dealt with, protected learning time, the cost is actually much more and, as I say, a of the unions he has also rejected it.
Barclay referred to media pressure when asked why he would not overturn the pay body’s recommendation, as ministers have done in the past. He told Sky News:
When we did, you were the first – I’m sure – to criticize us for not respecting independence. The difference here is that we have accepted these recommendations in full because we recognize that the system coming out of the pandemic has been under pressure.
Steven Morris
In Wales, emergency ambulance crews are responding to red calls (immediately life-threatening) and ‘select’ amber 1 calls (urgent but not immediately life-threatening) for conditions such as chest pains, stroke, gynecological emergencies and serious traffic accidents. Other Amber 1 calls can be answered after a remote clinical assessment.
A quarter of Wales Ambulance staff are members of the GMB and the trust said it expected the strike to have a “significant impact” on its ability to respond to 999 calls.
The trust is also concerned that there is a risk that individual staff will choose not to respond to even the most serious calls and there could also be solidarity actions by non-union staff. The military are not being brought in to drive ambulances in Wales.
Welsh Health Minister Eluned Morgan urged people to stock up on first aid kit supplies and limit activities that could cause injury.
Ambulances will only be able to attend to the most urgent calls on strike days. Please do not add additional pressure to the services. It is important to call 999 if you are in immediate danger, but we all need to consider very carefully how we use ambulance services in these [strike] days
He said everyone could help ease the pressure by stocking up on prescription and over-the-counter medicines for common ailments to reduce the risk of falling ill on strike days and taking extra care in the cold to avoid slips, trips and falls and accidents. to the road.
Updated at 08.46 GMT
Asked why he refuses to talk to unions about pay, Barclay says he doesn’t want to “divert money” from patient services. Pressed by union leaders’ repeated pleas for talks to try to resolve the dispute, he tells Sky News:
We have a process in terms of payment, a separate process, and we have accepted the recommendations from that in…