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
Image: 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?
Advertisement
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.
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
Please use Chrome browser for a more accessible video player
0:26
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).
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.
The mother of murdered teenager Brianna Ghey is calling on the government to introduce a ban on mobile phones in schools – a move she says will not only safeguard children, but also improve their behaviour and engagement in class.
In the lead-up to the attack, her killers had spent time on the dark web. At the same time, Brianna was also trapped online, struggling with a phone addiction.
Her mother Esther Ghey’s Phone Free Education campaign is driven by her personal experiences as a parent and the impact Brianna’s phone use had on her education.
Image: Brianna Ghey struggled with a mobile phone addiction, according to her mother
“All the arguments that me and Brianna had were down to her phone use,” Esther said.
“But even in school, she had issues and I used to have phone calls from the school saying that Brianna wouldn’t put her phone away.”
Brianna, who was transgender, struggled with an eating disorder and also self-harmed.
Her mother says the constant time she spent online exacerbated those issues, while impacting her behaviour at school, where she had 120 safeguarding logs and 116 behaviour incidents recorded by her teachers.
Image: Esther Ghey said she had calls from her daughter’s school saying that ‘Brianna wouldn’t put her phone away’
“It was so difficult as a parent, because I felt in one way that I was failing and then in another way, and this is really difficult for me to speak about, I was so annoyed with Brianna,” she recalled.
“I thought, why can’t you just go to school, get your head down and just focus on your education, because this is important.
“Only now, after two years of being immersed in this world, do I realise that actually, it’s so much harder than that.”
Research by the Children’s Commission has shown that 79% of secondary schools are still allowing pupils to bring their mobile phones into school, and even into classrooms.
Image: Brianna’s school introduced a ban on mobile phones in September last year
How phone ban is working at Brianna’s old school
Esther is campaigning for government guidance on phones to become statutory, with funding also set aside for the equipment to help schools implement the ban, arguing the lack of legislation is “setting children up to fail”.
At Birchwood Community High School in Warrington, where Brianna was a pupil, they introduced a ban on phones last September.
At the beginning of the day, pupils turn off their phones and place them in pouches, which are locked. At the end of the school day, the pouches are then unlocked.
Image: Pupils at Birchwood Community High School in Warrington place their phones in pouches, which are then locked
The headteacher, Emma Mills, said introducing these measures has come with several benefits.
“It’s had an impact in all areas of school, and it’s actually had a really positive impact in ways that I didn’t foresee,” said Ms Mills.
“Attendance has improved this year. In terms of behaviour, behaviour has improved. We’ve had no permanent exclusions this year in school, which is actually the first time since I’ve been headteacher in six years, there’s been no permanent exclusion.”
This summer, the school also saw its best-ever GCSE results in the core subjects of Science, maths, and English.
Image: Emma Mills, headteacher at Birchwood Community High School in Warrington
‘They can live without their phones’
For Ms Mills, another significant change has been the atmosphere in the school.
“They’re not as worried, they’re not as distracted,” Ms Mills said.
“They’ve realised that they can live without their phones. Something else we’ve really noticed is that it’s a bit louder in school at breaks and lunch times. It’s because they’re talking more, they’re interacting more, and they’re communicating more.”
The positive impact of a ban at Brianna’s old school has served as encouragement to Esther, who has written an open letter addressed to Sir Keir Starmer and Education Secretary Bridget Phillipson, asking for government support.
Police across the UK dealt with more than 3,000 protests over three months this summer – more than three times as many as just two years ago.
There were 3,081 protests this June, July, and August across England, Wales, Scotland and Northern Ireland, figures from the National Police Chiefs’ Council have revealed.
Last summer, when riots were raging across the country following the Southport murders, police dealt with 2,942 protests. In 2023, it was 928.
The summer months this year have been dominated by widespread demonstrations, some against the ban on Palestine Action and others against housing asylum seekers in hotels.
Image: Counter-protesters with police as people take part in a Stand Up To Racism rally in Orpington in August. Pic: PA
‘Increasing tension’
Gavin Stephens, chairman of the NPCC, said it was clear that there has been “more community tension and more division”, adding that “we all have a responsibility, policing included, to set the tone”.
“Anybody in a leadership position should think about how we can reduce and defuse tensions and not sow division,” Mr Stephens said.
The senior official said protests this year were a “chronic pressure” for police compared to last year’s disorder, which was acute.
“This is not talking about the volume of protest, and this is not a commentary from policing on people’s right to protest peacefully,” he said.
“We absolutely support that in a democracy, but we do know that there is a climate of increasing tension and polarity in what we’re seeing.”
He is convinced communities will be able to reunite and “reset”, and said claims that the UK is on the verge of civil disobedience are “exaggerated”.
The group of Thames Water lenders aiming to rescue the company have set out plans for £20.5bn of investment to bolster performance.
The proposals, submitted to the regulator for consideration, include commitments to spending £9.4bn on sewage and water assets over the next five years, up 45% on current levels, to prevent spills and leaks respectively.
Of this, £3.9bn would go towards the worst performing sewage treatment sites following a series of fines against Thames Water, and other major operators, over substandard storm overflow systems.
It said this would be achieved at the 2025-30 bill levels already in place, so no further increases would be needed, but it continued to argue that leniency over poor performance will be needed to effect the turnaround.
The creditors have named their consortium London & Valley Water.
It effectively already owns Thames Water under the terms of a financial restructuring agreed early in the summer but Ofwat is yet to give its verdict on whether the consortium can run the company, averting the prospect of it being placed in a special administration regime.
Please use Chrome browser for a more accessible video player
1:32
Is Thames Water a step closer to nationalisation?
Thames is on the brink of nationalisation because of the scale of its financial troubles, with debts above £17bn.
Without a deal the consortium, which includes investment heavyweights Elliott Management and BlackRock, would be wiped out.
Ofwat, which is to be scrapped under a shake-up of oversight, is looking at the operational plan separately to its proposed capital structure.
The latter is expected to be revealed later this month.
Sky News revealed on Monday that the consortium was to offer an additional £1bn-plus sweetener in a bid to persuade Ofwat and the government to back the rescue.
Please use Chrome browser for a more accessible video player
2:35
Thames Water handed record fine
Mike McTighe, the chairman designate of London & Valley Water, said: “Over the next 10 years the investment we will channel into Thames Water’s network will make it one of the biggest infrastructure projects in the country.
“Our core focus will be on improving performance for customers, maintaining the highest standards of drinking water, reducing pollution and overcoming the many other challenges Thames Water faces.
“This turnaround has the opportunity to transform essential services for 16 million customers, clean up our waterways and rebuild public trust.”
The government has clearly signalled its preference that a market-based solution is secured for Thames Water, though it has lined up a restructuring firm to advise on planning in the event the proposed rescue deal fails.
A major challenge for the consortium is convincing officials that it has the experience and people behind it to meet the demands of running a water company of Thames Water’s size, serving about a quarter of the country’s population.