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.
Two pro-Palestinian demonstrators have thrown red powder on Tower Bridge – just moments before leading runners in the London Marathon went past.
The protesters were arrested on suspicion of causing a public nuisance and remain in custody, said the Metropolitan Police.
A video shared by Youth Demand, which is calling for a trade embargo on Israel, shows two people jumping over a barrier that separates spectators from the race course.
The pair, wearing t-shirts that say “Youth Demand: Stop Arming Israel”, are then seen standing in the middle of the road on the bridge.
Image: Pic: LNP
They throw red powder in the air as an official marathon car goes past displaying the race time.
A motorbike with a cameraman on board continues along the route, while a second motorbike stops and one of the riders gets off and pushes the pair out of the way, just before the men’s elite runners pass.
Several police officers then jump over the barrier and detain the pair, the footage shows.
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There appeared to be no impact on the marathon.
More than 56,000 participants were expected to take part in the 26.2-mile race through the capital.
Sabastian Sawe of Kenya won the men’s elite race in a time of two hours, two minutes and 27 seconds, while Ethiopia’s Tigst Assefa shattered the women’s-only world record in two hours, 15 minutes and 50 seconds.
Assefa beat the previous best of two hours, 16 minutes and 16 seconds set last year in London by Kenyan Peres Jepchirchir.
The Metropolitan Police said in a statement: “At around 10.38am, two protesters from Youth Demand jumped over barriers at Tower Bridge and threw red paint on to the road.
“Marathon event staff intervened to remove the protesters from the path of the men’s elite race which was able to pass unobstructed.”
The force added that they were “quickly supported by police officers who arrested the protesters on suspicion of causing a public nuisance”.
The Met said the paint “appeared to be chalk-based” and was not expected to “present a hazard to runners yet to pass this point”.
Kemi Badenoch has not ruled out forming coalitions at a local level with Reform after the council elections next week.
Speaking to Sunday Morning with Trevor Phillips, the Conservative leader did however categorically rule out a pact with Nigel Farage’s party on a national level.
“I am not going into any coalition with Nigel Farage… read my lips,” she said.
However, she did not deny that deals could be struck with Reform at a local level, arguing that some councils might be under no overall control and in that case, “you have to do what is right for your local area”.
“You look at the moment, we are in coalition with Liberal Democrats, with independents,” she said. “We’ve been in coalition with Labour before at local government level.
“They [councillors] have to look at who the people are that they’re going into coalition with and see how they can deliver for local people.”
She added: “What I don’t want to hear is talks of stitch-ups or people planning things before the results are out. They have to do what is right for their communities.”
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A total of 23 councils are up for grabs when voters go to the polls on Thursday 1 May – mostly in places that were once deemed Tory shires, until last year’s general election.
It includes 14 county councils, all but two of which have been Conservative-controlled, as well as eight unitary authorities, all but one of which are Tory.
Ms Badenoch has set expectations low for the Tories, suggesting they could lose all the councils they are contesting.
The last time this set of councils were up for election was in 2021, when the Conservative Party was led by Boris Johnson who was riding high from the COVID vaccine bounce.
This breaking news story is being updated and more details will be published shortly.
Counter-terrorism police are investigating after an incident involving a crossbow and a firearm left two women injured in Leeds.
Police were called to Otley Road at 2.47pm on Saturday to reports of a “serious incident involving a man seen with weapons”, West Yorkshire Police said.
Officers arrived at the scene to find two women injured – and a 38-year-old man with a self-inflicted injury. All three were taken to hospital, with the man held under arrest, but their injuries are not believed to be life-threatening.
“Two weapons have been recovered from the scene, which were a crossbow and a firearm,” Counter Terrorism Policing North East said in a statement.
The incident happened on the ‘Otley Run’ pub crawl, with one venue saying it was closed for the evening due to “unforeseen circumstances”.
Image: Officers guard one of the crime scenes
Image: Officers inside the cordon in Leeds
Counter Terrorism Policing’s statement added: “Due to the circumstances surrounding the incident, Counter Terrorism Policing North East have taken responsibility for leading the investigation with the support of West Yorkshire Police.
“Extensive enquiries continue to establish the full circumstances and explore any potential motivation.”
Home Secretary Yvette Cooper described it as a “serious violent incident” and said she was being kept updated by police.
“Thank you to the police and emergency services for their swift response,” she said. “My thoughts are with the victims and all those affected by this attack.”
This breaking news story is being updated and more details will be published shortly.