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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3:05
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.
An MP has told Sky News she was attacked online by the Tate brothers after she participated in a debate in the House of Commons about violence against women.
The controversial duo, Andrew and Tristan Tate, are facing charges of rape and human trafficking in the UK – all of which they deny.
But they are still very active online, and according to Sorcha Eastwood, the MP for Lagan Valley, are targeting her.
In a document seen by Sky News, Tristan Tate has highlighted one of the MP’s tweets and writes in private correspondence: “MP, nice target, can we sue her?”
Sorcha Eastwood says at first she thought the replies were from parody accounts and not the Tate brothers.
Her original tweet was about Elon Musk, not the Tate brothers. The MP said Musk’s tweets should be looked at through a counter-extremism lens.
“I was really concerned, I was concerned because to me that is a direct attack for want of a better phrase on me serving my constituents.
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“I couldn’t believe that they decided to pick this random Northern Irish MP. The fact that it wasn’t even about them. This is something I didn’t go looking for.
“I think from my perspective, it’s a very, very sinister attempt to shut down important voices in public life, political discourse.”
It was only when she started noticing an uptick in abuse from other accounts she realised she had encountered some of the brothers’ followers.
“I had rape threats. I had death threats. I had people saying I should be hung from a lamppost. I had people saying I should be chopped into liver. I also had people then who were like we’ll waste 15 minutes raping Sorcha Eastwood.”
Image: A representative for the Tate brothers told Sky News that there was no targeted campaign against Sorcha Eastwood
A representative for the Tate brothers told Sky News that there was no targeted campaign against her.
They said: “Ms Eastwood has a distorted view regarding social media if she believes one is required to ‘invite or ask’ people to interact.
“Tristan Tate is entitled to his view in relation to her tweet regarding Elon Musk.”
The self-styled “misogynist influencer” Andrew Tate and his brother Tristan have both been charged with human trafficking, face allegations of trafficking minors, sexual intercourse with a minor and money laundering in Romania.
There is also a European arrest warrant for them as they are facing separate, unrelated charges of rape and human trafficking in the UK. They deny all charges.
Ms Eastwood now worries for others who don’t have a platform like her and who may not feel like they can speak out.
“If this is what has happened to me I have absolutely no doubt that this has happened to others where they have been attempted to be silenced.”
Keir Starmer has previously commented on the Tate brothers’ case in the Commons saying it is “a live issue”, but adding that “the principle is absolutely clear” in relation to whether the brothers should face justice.
Sorcha Eastwood says she wants to see the government do much more to protect against abuse online.
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Tate brothers deny wrongdoing
“I think ultimately the government has taken the wrong course on this. They need to step up.
“This should be an issue of national security as far as the radicalisation of young people online. It should be an issue in terms of the levels of misinformation, disinformation and the lack of trust that is had in our politics right across the UK and Europe.
“I want the government to help me, help every other person to crack down on this and get serious about it. And the only way they’ll be able to do that, is by hitting these tech companies in the only language which they understand, which is money and via robust legislation.”
A government spokesperson said: “Violence against women and girls is a scourge on our society which is why we have set out an unprecedented mission to halve these crimes within a decade.
“Tackling illegal abuse both online and offline is central to supporting victims and preventing harm in our communities and we will not hesitate to strengthen laws to deliver this mission.
“Last month, parts of the Online Safety Act came into force meaning companies must take action to protect users from illegal material including extreme sexual violence.
“Further protections from this summer will require platforms to protect children from harmful, misogynistic, and violent content.”
In parts of Birmingham, the stench is overwhelming – enough to make you heave.
At a block of flats in Highgate, in Birmingham city centre, we find a mountain of bin liners full of rubbish spewing out of the cavernous bin store, which is normally locked.
Mickel comes out to speak to us, while all around bin liners lie open, with the contents for all to see, including used nappies and rotting food.
Image: Mickel says they’ve had ‘foxes and rats, literally the size of cats’
Image: Outside Mickel’s flat in Highgate, bin liners lie open, spewing out rubbish
We both find it hard to keep talking amid the awful smell.
“We’ve had foxes and rats, literally the size of cats, flies, it’s just nasty, something needs to be done,” he says.
Image: Chris says the situation is ‘overwhelming’ as she’s ‘terrified of rats’
Around the corner, I meet Chris, in her dressing gown, popping the bins into her bin store beneath her flat before work.
She unlocks it, and although it isn’t bursting out on to the street yet, it is getting full.
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She says the situation is “overwhelming” as she’s “terrified of rats”. But, even so, she has sympathy for the striking bin workers.
“It’s not an easy job; they must have a heart of gold to do that job,” she says.
“Pay them whatever they need, they deserve it.”
Image: Striking bin workers at Lifford Lane tip, south of the city centre
Image: There’s an awful smell coming from a mountain of bin liners outside Mickel’s flat in Highgate
At Lifford Lane tip, south of the city centre, Brigette has pulled up alongside picketing workers. The back seat of her car is full of rubbish.
She apologises for the terrible waft, mixed with air freshener.
“It’s very pungent, isn’t it? Not nice,” she admits.
“It’s unfortunate, I have some sympathies for all the parties, but, equally, we have a duty of care to stay clean and tidy.”
She says she has her rubbish and that of her elderly aunt and plans to make weekly trips to the tip until a resolution in this pay dispute between the council and the Unite union is found.
The US is “our closest ally” but “nothing is off the table” in response to Donald Trump’s 10% tariffs on imports from the UK, the business secretary has said.
In a statement following the US president’s nearly hour-long address to the world, Business and Trade Secretary Jonathan Reynolds said: “We will always act in the best interests of UK businesses and consumers.
“That’s why, throughout the last few weeks, the government has been fully focused on negotiating an economic deal with the United States that strengthens our existing fair and balanced trading relationship.”
Mr Reynolds reiterated the statements from the prime minister and his cabinet over the past few days, saying the US is “our closest ally”, and the government’s approach is to “remain calm and committed to doing this deal, which we hope will mitigate the impact of what has been announced today”.
Image: Business Secretary Jonathan Reynolds says “nothing is off the table” following the tariffs announcement. Pic: PA
But he continued: “We have a range of tools at our disposal, and we will not hesitate to act. We will continue to engage with UK businesses, including on their assessment of the impact of any further steps we take.
“Nobody wants a trade war, and our intention remains to secure a deal. But nothing is off the table, and the government will do everything necessary to defend the UK’s national interest.”
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‘Get back round the negotiating table’, say Tories
The Conservative Party’s shadow business and trade secretary described the US president’s announcement as “disappointing news which will worry working families across the country”.
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Sky’s Ed Conway examines how economies across the world are impacted by tariffs
Andrew Griffith hit out at the government for having “failed to negotiate with President Trump’s team for too many months after the election, failed to keep our experienced top trade negotiator, and failed to get a deal to avoid the imposition of these tariffs by our closest trading partner”.
“The chancellor’s emergency budget of just a week ago with its inadequate headroom is now at risk, casting uncertainty about more taxes or spending cuts,” he continued. “Sadly, it is British businesses and workers who will pay the price for Labour’s failure.”
He called on ministers to “swallow their pride” and “get back round the negotiating table to agree a fair deal to protect jobs and consumers in both the UK and the US alike”.
Relief in Westminster – but concessions to Trump to come
It has been quite a rollercoaster for the government, where they went from the hope that they could avoid tariffs, that they could get that economic deal, to the realisation that was not going to happen, and then the anticipation of how hard would the UK be hit.
In Westminster tonight, there is actual relief because the UK is going to have a 10% baseline tariff – but that is the least onerous of all the tariffs we saw President Trump announce.
He held up a chart of the worst offenders, and the UK was well at the bottom of that list.
No 10 sources were telling me as President Trump was in the Rose Garden that while no tariffs are good, and it’s not what they want, the fact the UK has tariffs that are lower than others vindicates their approach.
They say it’s important because the difference between a 20% tariff and a 10% tariff is thousands of jobs.
Where to next? No 10 says it will “keep negotiating, keep cool and calm”, and reiterated Sir Keir Starmer’s desire to “negotiate a sustainable trade deal”.
“Of course want to get tariffs lowered. Tomorrow we will continue with that work,” a source added.
Another source said the 10% tariff shows that “the UK is in the friendlies club, as much as that is worth anything”.
Overnight, people will be number-crunching, trying to work out what it means for the UK. There is a 25% tariff on cars which could hit billions in UK exports, in addition to the blanket 10% tariff.
But despite this being lower than many other countries, GDP will take a hit, with forecasts being downgraded probably as we speak.
I think the government’s approach will be to not retaliate and try to speed up that economic deal in the hope that they can lower the tariffs even further.
There will be concessions. For example, the UK could lower the Digital Services Tax, which is imposed on the UK profits of tech giants. Will they loosen regulation on social media companies or agricultural products?
But for now, there is relief the UK has not been hit as hard as many others.
Liberal Democrat leader Sir Ed Davey has reacted furiously to Mr Trump’s announcement of a “destructive trade war”, and called on the government to stand up against “Trump’s attempts to divide and rule”.
“The prime minister should bring our Commonwealth and European partners together in a coalition of the willing against Trump’s tariffs, using retaliatory tariffs where necessary and signing new trade deals with each other where possible.”
Speaking on Wednesday evening at a White House event entitled ‘Make America Wealthy Again’, the US president unleashed sweeping tariffs across the globe.
Mr Trump held up a chart detailing the worst offenders – which also showed the new tariffs the US would be imposing.
The UK’s rate of 10% was perhaps a shot across the bow over the 20% VAT rate, though the president’s suggested a 10% tariff imbalance between the two nations. Nonetheless, tariffs of 10% could directly reduce UK GDP by between 0.01% and 0.06%, according to Capital Economics.
A 25% duty on all car imports from around the world is also being imposed from midnight in the US – 5am on Thursday, UK time.
The UK government had been hoping to negotiate an economic deal with the US in a bid to avoid the tariffs, but to no avail. The government says negotiations will continue.
The Confederation of British Industry said “negotiating stronger trading relationships with all like-minded partners will be foundational to any success”.
The business secretary is expected to make a statement in the House of Commons on Thursday, and we are also expecting to hear from the prime minister.