The number of people phoning 999 appears to have dropped in parts of England as thousands of ambulance staff and paramedics strike until midnight.
The West Midlands Ambulance Trust thanked people for heeding their advice to only call in an emergency as ambulance trusts reported receiving fewer calls.
The drop in calls comes as health leaders have urged people to still phone for an ambulance if they are in a life-threatening emergency.
It is feared some people in desperate need of help will not phone 999 during the strike action.
Hundreds of members of the army, navy and RAF have been drafted in to cover as paramedics, technicians, control room workers and other staff in England are on strike.
All Category 1 calls (the most life-threatening, such as cardiac arrest) are being responded to during the walkouts, while some ambulance trusts have agreed exemptions with unions for specific incidents within Category 2 (serious conditions, such as stroke or chest pain).
Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), said: “There may be a number of reasons why 999 calls are dropping – hesitancy may be a key factor during the industrial action.
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“We want to reassure patients and the public that if they need emergency care, A&Es remain open.”
The Welsh Ambulance Service has said demand is “manageable” but any “influx of calls would put significant pressure on our service”.
Image: Members of the armed forces have been drafted in to help
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Members of the armed forces are not due to be sent on critical emergency callouts or to carry out clinical tasks.
Meanwhile, the East Midlands Ambulance Service said it was too early to say how the service was coping.
Up to half of its more than 4,000 workforce were GMB members who were striking.
South Central Ambulance Service said its main impact from strikes was patient transport services in Sussex and Surrey, rather than urgent and emergency care services.
The London Ambulance Service declined to comment on how services were running.
Image: Ambulance workers take part in strike action in London
Thursday and Friday ‘expected to be busy’
Meanwhile, a chief executive of a large northern teaching trust told the Health Service Journal (HSJ) it had “so far not (been) as bad as I’d feared in terms of hospital pressures – in fact, (emergency departments) are less pressured than usual.
“We haven’t seen cars/taxis with patients arriving in large numbers but the problem is that much of the risk is not currently visible to us given people will be at home.
“We therefore expect very busy days on Thursday and Friday.”
It comes as the Royal Albert Edward Infirmary in Wigan declared a critical incident and said it was full after facing “unprecedented pressures” in its A&E department.
The strike action has taken place as there is a bitter war of words between unions and Health Secretary Steve Barclay who has said he will not back down on pay.
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‘I cannot express how bad it is’ – paramedic
Health secretary accused of ‘blatant lie’
Mr Barclay said the Unite, Unison and GMB unions had “refused” to work with the government at the national level to set out plans for dealing with the strikes.
But the unions said all those agreements had been made locally and were in place.
From a picket line in Longford, Coventry, Unite general secretary Sharon Graham accused Mr Barclay of a “blatant lie” for saying ambulance unions had taken a “conscious decision” to inflict harm on patients.
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Health sec criticises timing of ambulance strike
Meanwhile, a paramedic in Nottinghamshire said patients’ lives have been at risk for a long time due to issues in the NHS.
Tom, 33, from the East Midlands Ambulance Service, said: “I’ve attended elderly patients who have been on the floor with broken hips for over 20 hours.
“They’ve been waiting that long that their limbs have started to become necrotic (dying tissue), resulting in major surgery to remove said limbs.”
Image: Sharon Graham (centre) joins ambulance workers on the picket line in Coventry
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Sky’s Jason Farrell looks at the impact of ambulance staff walkouts on patients and those who care for them.
‘Don’t get blind drunk’
A former Royal Marine who is among striking health workers described it as “demoralising” to spend entire shifts waiting outside hospitals with patients stuck in the back of ambulances as he demanded “something needs to change”.
Harry Maskers from Cardiff, who works for the Welsh Ambulance Service, said that while he was unable to strike during his military career, he was taking the opportunity to do so now, with “the kicker” being the government’s refusal to discuss the issue of pay.
Mr Barclay had earlier urged the public to “use their common sense in terms of what activities they do” while ambulance workers are on strike, while the medical director of NHS England Professor Sir Stephen Powis urged people not to get “blind drunk”.
The walkout by ambulance staff and paramedics comes as nurses in Scotland overwhelmingly rejected the latest pay offer from the Scottish government, in a move which could see members of the Royal College of Nursing (RCN) take strike action for the first time ever.
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Health Secretary Steve Barclay says people should use
Meanwhile, National Highways workers will go on strike from Thursday until Christmas Day in the latest phase of industrial action by the biggest civil service union.
The strike involves members of the Public and Commercial Services union (PCS) working as on-road traffic officers and regional operating centre operatives, in London and southeast England.
It comes as planned strikes by railway cleaners in a dispute over pay have been called off.
More than 1,000 cleaners, who are members of the Rail, Maritime and Transport union, would have been involved.
“The target was never particularly ambitious,” says the Institute for Fiscal Studies (IFS) about Labour’s plan to add two million extra NHS appointments during their first year in power.
In February, Health Secretary Wes Streeting announced they had achieved the feat early. He recently described the now 3.6m additional appointments achieved in their first eight months as a “massive increase”.
But new data, obtained by independent fact checking charity Full Fact and shared exclusively with Sky News, reveals this figure actually signalled a slowing down in new NHS activity.
There was an even larger rise of 4.2m extra appointments over the same period the year before, under Rishi Sunak’s government.
The data also reveals how unambitious the target was in the first place.
We now know two million extra appointments over the course of a year represents a rise of less than 3% of the almost 70 million carried out in the year to June 2024.
In the last year under Mr Sunak, the rise was 10% – and the year before that it was 8%.
Responding to the findings, Sarah Scobie, deputy director of independent health and social care think tank the Nuffield Trust, told Sky News the two million target was “very modest”.
She said delivering that number of appointments “won’t come close to bringing the treatment waiting list back to pre-pandemic levels, or to meeting longer-term NHS targets”.
The IFS said it was smaller than the annual growth in demand pressures forecast by the government.
What exactly did Labour promise?
The Labour election manifesto said: “As a first step, in England we will deliver an extra two million NHS operations, scans, and appointments every year; that is 40,000 more appointments every week.”
We asked the government many times exactly how it would measure the pledge, as did policy experts from places like the IFS and Full Fact. But it repeatedly failed to explain how it was defined.
Leo Benedictus, a journalist and fact-checker at Full Fact, told Sky News: “We didn’t know how they were defining these appointments.
“When they said that there would be more of them, we didn’t know what there would be more of.”
Image: Leo Benedictus
Even once in government, initially Labour did not specify their definition of “operations, scans, and appointments”, or what the baseline “extra” was being measured against.
This prevented us and others from measuring progress every month when NHS stats were published. Did it include, for instance, mental health and A&E appointments? And when is the two million extra comparison dating from?
Target met, promise kept?
Suddenly, in February, the government announced the target had already been met – and ever since, progress on appointments has been a key boast of ministers and Labour MPs.
At this point, they did release some information: the definition of procedures that allowed them to claim what had been achieved. They said the target involved is elective – non-emergency – operations excluding maternity and mental health services; outpatient appointments and diagnostic tests.
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3:05
Why has Starmer axed NHS England?
However, we still did not have a comprehensive baseline to measure the two million increase against.
The government data instead relied on a snapshot: comparing the number of appointments carried out from July to November 2024 with the number from July to November 2023, and adjusted them for the number of working days in each period.
This did not tell us if the NHS had already been adding appointments under the Conservatives, and at what pace, and therefore whether this target was a big impressive ramping up of activity or, as it turns out, actually a slowing down.
Since then, a number of organisations, like Full Fact, have been fighting with the government to release the data.
Mr Benedictus said: “We asked them for that information. They didn’t publish it. We didn’t have it.
“The only way we could get hold of it was by submitting an FOI request, which they had to answer. And when that came back about a month later, it was fascinating.”
This finally gives us the comparative data allowing us to see what the baseline is against which the government’s “success” is being measured.
A Department of Health and Social Care spokesperson said: “On entering office last July, the secretary of state [Wes Streeting] was advised that the fiscal black hole meant elective appointments would have to be cut by 20,000 every week.
“Instead, this government provided the extra investment and has already delivered 3.6 million additional appointments – more than the manifesto commitment the British public voted for – while also getting more patients seen within 18 weeks.
“In the nine months since this government took office, the waiting list has dropped by over 200,000 – more than five times as much as it had over the same period the previous year – and also fell for six consecutive months in a row.”
Image: Health Secretary Wes Streeting. Pic: PA
We put this to Jeremy Hunt, Rishi Sunak’s chancellor during his last two years as prime minister, and health secretary for six years under David Cameron and Theresa May.
He said: “What these numbers seem to show is that the rate of appointments was going up by more in the last government than it is by this government. That’s really disappointing when you look at the crisis in the NHS.
“All the evidence is that if you want to increase the number of people being treated, you need more capacity in the system, and you need the doctors and nurses that are there to be working more productively.
“Instead what we’ve had from this government is the vast majority of the extra funding for the NHS has gone into pay rises, without asking for productivity in return.”
Image: Jeremy Hunt speaks to Sky’s Sam Coates
Edward Argar, shadow health secretary, accused the government of a “weak attempt […] to claim credit for something that was already happening”.
“We need to see real and meaningful reform that will genuinely move the dial for patients,” he added.
Is the NHS getting better or worse?
New polling carried out by YouGov on behalf of Sky News this week also reveals 39% of people think the NHS has got worse over the past year, compared with 12% who think it’s got better.
Six in 10 people say they do not trust Keir Starmer personally on the issue of the NHS, compared with three in 10 who say they do.
That is a better rating than some of his rivals, however. Just 21% of people say they trust Nigel Farage with the NHS, and only 16% trust Kemi Badenoch – compared with 64% and 60% who do not.
Ed Davey performs better, with 30% saying they trust him and 38% saying they do not.
Ms Scobie of the Nuffield Trust told Sky News “the government is right to make reducing long hospital treatment waits a key priority […] but much faster growth in activity is needed for the NHS to see a substantial improvement in waiting times for patients.”
The government is correct, however, to point out the waiting list having dropped by more than 200,000 since it’s been in office. This is the biggest decline between one July and the following February since current waiting list statistics were first published under Gordon Brown.
The percentage of people waiting less than 18 weeks for treatment is also falling for the first time, other than a brief period during the pandemic, for the first time in more than a decade.
The latest figures show 6.25m people waiting for 7.42m treatments (some people are on the list for more than one issue). That means more than one in 10 people in England are currently waiting for NHS treatment.
There continues to be a fall in the number who have been waiting longer than a year. It’s now 180,242, down from almost 400,000 in August 2023 and over 300,000 in June 2024, the Conservatives’ last month in power.
But that number is still incredibly high by historical standards. It remains over 100 times higher than it was before the pandemic.
The government has a separate pledge that no more than 8% of patients will wait longer than 18 weeks for treatment, by the time of the next election. Despite improvements in recent months, currently more than 40% wait longer than this.
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.
Sir Keir Starmer’s claim he is U-turning on cutting winter fuel payments for pensioners because he now has the money is not “credible”, Harriet Harman has said.
The Labour peer, speaking to Sky News political editor Beth Rigby on the Electoral Dysfunction podcast, said the prime minister made the move as it was so unpopular with voters.
He and his ministers had insisted they would stick to their guns on the policy, even just hours before Sir Keir revealed his change of heart at PMQs
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Winter fuel payment cuts to be reversed
Baroness Harman said: “It’s always been contested and always been unpopular.
“But the final straw that broke the camel’s back was the elections. The council elections and the Runcorn by-election, where the voters were saying, ‘this is not the change we voted for’.
“At the end of the day, you cannot just keep flying in the face of what voters – particularly if they’re people who previously voted for you – wanted.”
Baroness Harman is unconvinced by Sir Keir’s claim he can U-turn because there is more money due to good economic management by the government.
“I don’t think that’s credible as an argument,” she said.
“It really is the fact that voters just said ‘this is not the change we voted for, we’re not going to have this’.”
The challenge for the government now, she said, is deciding who will get the allowance moving forward, when they’ll get it, and when it will all be announced.
The Institute for Fiscal Studies has looked into the government’s options after Sir Keir Starmer said he is considering changes to the cut to winter fuel payment (WFP).
The government could make a complete U-turn on removing the payment from pensioners not claiming pension credit so they all receive it again.
There could be a higher eligibility threshold. Households not claiming pension credit could apply directly for the winter fuel payment, reporting their income and other circumstances.
Or, all pensioner households could claim it but those above a certain income level could do a self-assessment tax return to pay some of it back as a higher income tax charge. This could be like child benefit, where the repayment is based on the higher income member of the household.
Instead of reducing pension credit by £1 for every £1 of income, it could be withdrawn more slowly to entitle more households to it, and therefore WFP.
At the moment, WFP is paid to households but if it was paid to individuals the government could means-test each pensioner, rather than their household. This could be based on an individual’s income, which the government already records for tax purposes. Individuals who have a low income could get the payment, even if their spouse is high income. This would mean low income couples getting twice as much, whereas each eligible house currently gets the same.
Instead of just those receiving pension credit getting WFP, the government could extend it to pensioners who claim means-tested welfare for housing or council tax support. A total of 430,000 renting households would be eligible at a cost of about £100m a year.
Pensioners not on pension credit but receiving disability credits could get WFP, extending eligibility to 1.8m households in England and Scotland at a cost of about £500m a year.
Pensioners living in a band A-C property could be automatically entitled to WFP, affected just over half (6.3m).
Chancellor Rachel Reeves has committed to just one major fiscal event a year, meaning just one annual budget in the autumn.
Autumn budgets normally take place in October, with the last one at the end of the month.
If this year’s budget is around the same date, it will leave little time for the extra winter fuel payments to be made, as they are paid between November and December.
Business Secretary Jonathan Reynolds told the Electoral Dysfunction podcast the economy will have to be “strong enough” for the government to U-turn on winter fuel payment cuts.
He also said the public would have to wait for the budget for any announcement.
Before that, there had been calls for festivals to reconsider booking the band over their political stances, and several have done, which prompted artists like Brian Eno, the Mystery Jets and CMAT to sign an open letter accusing Westminster and the British media of a campaign to “remove Kneecap from the public eye”.
They put their names to wording that said “in a democracy, no political figures… have the right to dictate who does and does not play at music festivals.”
So what’s the reality like for artists who are outspoken at a time when the world is so divided?
As some of the biggest names in music gathered in London for the Ivors, an annual celebration of songwriting, Self-Esteem – aka Rebecca Lucy Taylor – said the level of scrutiny can be “terrifying”.
‘The problem with the internet’
She told Sky News: “The problem with the internet is you say one thing, which gets scrutinised, and then you shit yourself, you really do… then you’re advised not to. And then you’re like ‘don’t advise me not to!’
“You second-guess anything you want to say any more… but any time I do that, I think ‘well that’s why you’ve got to say it then’.”
She said it can be frustrating that focus turns on to pop stars’ opinions instead of “the people doing the bad things”.
Former Little Mix singer Jade said: “To be a pop artist these days, it’s not just about music, it’s: ‘What’s your political stance?’
“I’ve always been quite vocal about those things, but in doing so you have even more of a scary spotlight on you, constantly assessing what your thoughts are as a human…it is scary.”
Trinidad-born London artist Berwyn, whose songs depict his struggles with UK immigration, says: “Silencing freedom of speech… is a road we don’t want to walk down.
“I’m not a politician, this is a very complicated issue, but I do absolutely believe in a human’s right to express themselves freely.”
But is that freedom of speech dependent on what side you’re coming from?
Image: Berwyn speaking to Sky News
‘Unethical investments’
Soon, an event called Mighty Hoopla will take place at Brockwell Park as part of its programme of six festivals this summer.
Artists performing at that are coming under increased pressure from pro-Palestine groups to quit because it’s owned by a company called Superstruct, which has links to an American investment firm called KKR.
Critics argue that any KKR-affiliated events should be a red flag to artists as campaigners claim it “invests billions of pounds in companies” that do things like “develop Israeli underground data centres”, and they say it has shares in companies that “advertise property on illegally occupied land in the West Bank”.
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Mighty Hoopla itself has said while it “cannot control investments made in our parent companies”, it wants to “state its clear opposition to KKR’s unethical investments”.
And Superstruct – which puts on over 80 festivals around the world – says while horrified by the crisis in Gaza: “We are aware that there is a significant amount of debate… around our festivals.
“Our owners, made up of our promoters and several investment firms, support us to achieve the highest standards… fans and artists rightly expect.”
They insist that operationally, Superstruct is independently run and all its “revenue and profits… remains entirely within our business… towards the ongoing development… of our festivals.”
Even deciding where to perform can have political connotations for musicians these days.
As Tom Gray, a founding member of the rock band Gomez, now chair of the Ivors, explains: “The amount of commercial interest required to get a young artist into the public eye means they have to keep their head down a lot and that’s a terrible shame.
“It’s not just artistic expression, but personal human expression is one of the fundamental things that allows people to feel they have agency.”