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Ambulance and hospital trusts across the country have declared critical incidents as a result of “sustained” and “unprecedented” pressure on services.

Declaring a critical incident allows trusts to prioritise the patients most in need and to instigate additional measures to protect patient safety, trusts said.

It comes as nurses were striking for a second day on Tuesday, and as fears grow over the impact of an ambulance strike on Wednesday – when thousands of paramedics, technicians, control room workers and other staff in England and Wales are set to walk out.

The following services have declared critical incidents:

• North East Ambulance Service
• South East Coast Ambulance Service
• East of England Ambulance Service
• Portsmouth Hospitals University NHS Trust
• Nottingham and Nottinghamshire’s health and care system
• South Central Ambulance Service NHS Foundation Trust
• Yorkshire Ambulance Service

Strikes latest – follow live updates

Members of the Royal College of Nursing (RCN) on the picket line outside the Queen Elizabeth Hospital, Birmingham
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Members of the Royal College of Nursing (RCN) at the Queen Elizabeth Hospital in Birmingham are among those striking

The services said they took their decisions due to pressures including 999 call volumes and hospital handover delays. All the trusts have urged members of the public to call 999 only in the case of a serious medical emergency.

As well as prioritising certain patients, critical incident status allows trusts to call off training sessions and bookings for non-emergency transportation, and call on other providers for help.

What have the different trusts said?

North East Ambulance Service, which operates across Northumberland, Tyne and Wear, County Durham, Darlington and Teesside, said the decision was made there as a result of “significant delays for more than 200 patients waiting for an ambulance, together with a reduction in ambulance crew availability to respond because of delays in handing over patients at the region’s hospitals”.

Chief operating officer Stephen Segasby said: “Our service is under unprecedented pressure. Declaring a critical incident means we can focus our resources on those patients most in need and communicates the pressures we are under to our health system partners who can provide support.”

He said the trust had been operating at “its highest level of operational alert since 5 December”.

South East Coast Ambulance Service, which covers Brighton and Hove, East Sussex, West Sussex, Kent, Surrey and North East Hampshire, said it had experienced “more than a week of sustained pressure across our 999 and 111 services, significantly impacting on our ability to respond to patients”.

A spokesperson said the situation would be kept under close review.

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The East of England Ambulance Service, which works in Bedfordshire, Hertfordshire, Essex, Norfolk, Suffolk and Cambridgeshire, said NHS services in the region “are currently under huge pressure”, while London Ambulance Service also said its 999 and 111 services “remain extremely busy” and it would be prioritising the “sickest and most severely injured patients”.

Ambulances could be seen queuing outside Lister Hospital in Stevenage, Hertfordshire, on Tuesday.

Nottingham University Hospitals NHS Trust said some appointments would be rescheduled. Medical director Dr Keith Girling said staff were working “tirelessly” to deal with a “large number of people with illnesses arriving in emergency departments seeking assistance”.

Dr Girling continued: “We regret that this will impact patients who were due to receive planned care over the next few days and sincerely apologise to all those affected.”

A spokesperson for the hospital reassured patients that these appointments “will be rescheduled as soon as possible.”

Their statement added: “If your relative is due to be discharged from hospital and needs to be collected, please do so as early as possible. This will help our teams and free up a hospital bed for someone waiting to be admitted.”

In a statement, Portsmouth Hospitals University NHS Trust, which covers health services across Portsmouth and South East Hampshire, said “demand for an emergency response is far outstripping the capacity available… at this time”.

It continued: “There are significant and unacceptable delays currently and we apologise for this. We are doing everything in our power to meet the current demand. Our capacity will only be used for life-threatening conditions or injuries.”

Ambulance workers set to stage strikes

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Nurse: ‘We’re committed to continue strikes’

Thousands of nurses are staging a second walkout today, while ambulance workers who are GMB union members are striking on Wednesday. Both are calling for better pay, working conditions and improved conditions for patients.

The government has announced controversial plans to deploy more than 1,000 civil servants and 1,200 troops to cover striking ambulance workers and Border Force staff, who are preparing to walk out for eight days from 23 December until New Year’s Eve.

Unions branded the move a “desperate measure” and warned the servicemen and women are not “sufficiently trained” to plug staffing gaps on the front line.

During the ambulance strike, military personnel will not drive ambulances on blue lights for the most serious calls, but are expected to provide support on less serious calls.

Negotiations over which incidents should be exempt from strike action

Unions and ambulance services are still negotiating to work out which incidents should be exempt from strike action.

All Category 1 calls (the most life-threatening, such as cardiac arrest) will be responded to, while some ambulance trusts have agreed exemptions with unions for specific incidents within Category 2 (serious conditions, such as stroke or chest pain).

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It means those who suffer trips, falls or other non-life-threatening injuries may not receive treatment.

The London Ambulance Service has said that “patients whose conditions are not life-threatening are unlikely to get an ambulance on industrial action days”.

GMB members are set to stage a second ambulance worker walkout on 28 December.

Rachel Harrison, a national secretary at the GMB trade union, has told MPs that unless the health secretary is willing to talk about pay, ambulance strikes will go ahead.

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Mum diagnosed with cancer tells of the day her life changed ahead of assisted dying vote

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Mum diagnosed with cancer tells of the day her life changed ahead of assisted dying vote

There is a lot at stake this week for Sophie Blake, a 52-year-old mother to a young adult, who was diagnosed with stage four cancer in May 2023.

As MPs vote on whether to change the law to allow assisted dying, Sophie tells Sky News of the day her life changed.

“One night I woke up and as I turned I felt a sensation of something in my breast actually move, and it was deep,” she says, speaking from her home in Brighton.

“Something fluidy, a very odd sensation. I woke up and made a doctor’s appointment.”

Sophie underwent an ultrasound followed by a biopsy before she was taken to a room in the clinic and offered water.

“They said, ‘a hundred percent, we believe you have breast cancer’.”

But it was the phone call with her mother that made it feel real.

More on Assisted Dying

“My mum had been waiting at home. She phoned me and said ‘How is it darling?’ and I said ‘I’ve got breast cancer,’ and it was just that moment of having to say it out loud for the first time and that’s when that part of my life suddenly changed.”

Sophie says terminal cancers can leave patients dreading the thought of suffering at the end of their lives.

“What I don’t want to be is in pain,” she says. “If I am facing an earlier death than I wanted then I want to be able to take control at the end.”

Assisted dying, she believes, gives her control: “It’s an insurance policy to have that there.”

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Why is assisted dying so controversial and where is it legal?
UK on ‘slippery slope’ Justice Minister says ahead of vote

On Friday, the government is set to debate the issue before voting on it. Sophie hopes they’ll back the proposal.

“It should be my choice to be able to have a compassionate death,” she says.

There has been much debate about the bill since details about how it would work were published earlier this month.

On Friday, former prime minister Gordon Brown became the latest senior political figure to share his opinion on the matter, coming out as against the legalisation of assisted dying, based on his experience of his own daughter’s death.

Disability rights advocate Lucy Webster warns that for people like Sophie to have that choice, others could face pressure to die.

Lucy Webster, disability rights advocate
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Lucy Webster

“All around the world, if you look at places where the bill has been introduced, they’ve been broadened and broadened and broadened,” she tells Sky News.

Lucy is referring to countries like Canada and Netherlands, where eligibility for assisted deaths have widened since laws allowing it were first passed.

Lucy, who is a wheelchair user and requires a lot of care, says society still sees disabled people as burdens which places them at particular risk.

“I don’t know a single disabled person who has not at some point had a stranger come up to us and say, ‘if I were you, I’d kill myself’,” she says.

The assisted dying bill, she says, reinforces the view that disabled lives aren’t worth living.

“I’ve definitely had doctors and healthcare professionals assume that my quality of life is inherently worse than other people’s. That’s a horrible assumption to be faced with when [for example] you’ve just gone to get antibiotics for a chest infection. There are some really deep-seated medical views on disability that are wrong.”

Under the plans, a person would need to be terminally ill and in the final six months of their life, and would have to take the fatal drugs themselves.

Among the safeguards are that two independent doctors must confirm a patient is eligible for assisted dying and that a High Court judge must give their approval. But the bill does not make clear if that is a rubber-stamping exercise or if judges will have to investigate cases including risks of coercion.

Julian Hughes, honorary professor at Bristol Medical School, says there’s a very big question about whether courts have the room to take on such a task.

Julian Hughes, honorary professor at Bristol Medical School
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Julian Hughes

“At the moment in the family division I understand there are 19 judges and they supply 19,000 hours of court hearing in a year, but you’d have to have an extra 34,000,” he explains.

“We shouldn’t fool ourselves and think that there wouldn’t be some families who would be interested in getting the inheritance rather than spending the inheritance on care for their elderly family members. We could quickly become a society in which suicide becomes normalised.”

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Young people to lose benefits if they refuse work and training, says minister

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Young people to lose benefits if they refuse work and training, says minister

Young people will lose their benefits if they refuse to take up work and training opportunities, a minister has said ahead of announcing measures to cut the welfare bill.

Liz Kendall, the work and pensions secretary, told Sky’s Sunday Morning with Trevor Phillips that “conditions” will be attached to new skills opportunities the government intends to create.

Politics live: MP proposing assisted dying bill responds to claims it’s a ‘slippery slope’

With a record number of young people currently unemployed, Labour promised in its manifesto a “youth guarantee” for 18-21 year olds to have access to training, an apprenticeship, or support to find work.

“If people repeatedly refuse to take up the training work responsibilities, there will be sanctions on their benefits,” Ms Kendall said.

“The reason why we believe this so strongly is that we believe in our responsibility to provide those new opportunities which is what we will do. We will transform those opportunities, but young people will be required to take them up.”

The Labour government has said it will stick to a commitment under the former Tory administration to reduce the welfare bill by £3bn over five years.

More on Benefits

The Public Accounts Committee's report says the DWP has relatively few programmes that directly target people from ethnic minority backgrounds

Ms Kendall said her party will bring in its “own reforms” to achieve that target, though did not elaborate further.

The Conservatives had planned to change work capability rules to tighten eligibility, so around 400,000 more people signed off sick long-term would be assessed as needing to prepare for work by 2028/29 to deliver the savings.

Asked whether these people would ultimately be denied their current benefits under Labour’s plans, Ms Kendall told the BBC’s Sunday With Laura Kuenssberg: “I’m saying we will bring forward our own reforms. You wouldn’t expect me to announce this on your programme.

“But my objective is that disabled people should have the same chances and rights to work as everybody else.”

The latest official forecasts published by the government show the number of people claiming incapacity benefits is expected to climb from around 2.5 million in 2019 to 4.2 million in 2029.

Last year there were just over three million claimants.

Ms Kendall will launch proposals on Tuesday designed to “get Britain working” amid concerns about the soaring unemployment rate.

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The white paper is expected to include the placement of work coaches in mental health clinics and a “youth guarantee” aimed at ensuring those aged 18-21 are working or studying.

Ministers are also looking at a subsidised jobs scheme, Sky News revealed last week.

The UK remains the only G7 country that has higher levels of economic inactivity now than before the pandemic.

Ms Kendall said the reasons are “complex” and include the fact that the UK is an older and sicker nation.

Asked whether she believes “normal feelings” are being “over-medicalised”, she said that while some people may be “self-diagnosing” themselves with mental health issues it is a “genuine problem”.

“There’s not one simple thing. You know, the last government said people were too bluesy to work.

“I mean, I don’t know who they were speaking to. There is a genuine problem with mental health in this country.”

Ms Kendall’s language was softer than Sir Keir Starmer, who this weekend promised a crackdown on “criminals” who “game the system” .

Writing in the Mail on Sunday, he said: “Make no mistake, we will get to grips with the bulging benefits bill blighting our society.”

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Man fighting for his life after stabbing on Westminster Bridge

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Man fighting for his life after stabbing on Westminster Bridge

A man is fighting for his life after a stabbing on Westminster Bridge, police have said.

Officers were called to the scene at around 10.45am on Sunday to reports of a fight and found a man with a stab injury. He was taken to hospital in critical condition.

Westminster Bridge is closed with investigations ongoing.
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Westminster Bridge is closed with investigations ongoing.

Three people have been arrested on suspicion of attempted murder and another has been arrested on suspicion of affray.

Two of those arrested were taken to hospital with minor facial injuries, the Met Police said.

It is understood the incident is not being treated as terror-related.

The road remains closed, with the police investigation ongoing.

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