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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0:48
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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0:48
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.
The families of the British couple killed in the Lisbon funicular crash have said they are “heartbroken” as they paid tribute to them.
Kayleigh Smith, 36, and William Nelson, 44, died alongside 14 others in Wednesday’s incident, including another British victim who has not yet been named.
Ms Smith graduated from the Arden School of Theatre in Manchester, where Mr Nelson ran the master’s degree in directing.
In a statement shared by Cheshire Police, Ms Smith’s family said: “Kayleigh was loved by family and friends for her wit and humour, her kind and caring nature came to the fore in her work as a funeral operative.
“She was also a talented theatre director and had just completed a Master’s Degree. They both leave family and friends heartbroken.”
Mr Nelson’s younger brother, who was not named in the statement, added: “Words cannot begin to describe how our family and friends are feeling right now but here is the best attempt. This week, due to a tragic accident in Lisbon, Portugal, we lost Will Nelson, who was not just my big brother but everyone’s.
“He was always kind, selfless, and protective, and the world does not feel right or normal without him. He was and has always been my hero, and we will miss you always. Love you, rest in peace you legend.”
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‘We felt no brakes anymore’
MADS theatre in Macclesfield, Cheshire, said Ms Smith was a “valued member of our society” who will be “greatly missed”.
It said she was an award-winning director and actress, who had also done multiple crew and front-of-house roles.
Macclesfield MP Tim Roca paid tribute to Ms Smith, saying she was a “hugely talented theatre director” who “poured her creativity, energy and kindness into every production”.
Mr Nelson was “equally dedicated to nurturing creativity and inspiring the next generation” and “his loss will be felt deeply by colleagues and students alike”, the MP added.
Hours before the crash, Ms Smith posted pictures on Instagram of their first day in Lisbon with the caption: “Churches and castles, tiles and trams.”
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3:53
Lisbon crash: What happened?
Five Portuguese citizens died when the packed carriage plummeted out of control – four of them workers at a charity on the hill – but most victims were foreigners.
Police said the other fatalities were two Canadians, two South Koreans, one American, one French citizen, one Swiss and one Ukrainian.
All but one were declared dead at the scene – and 21 others in the packed carriage were injured.
The yellow carriages of the Gloria funicular are a big draw for tourists, as well as a proud symbol of the Portuguese capital.
The journey is just 265m (870ft) up a steep hill and takes three minutes, with two carriages travelling in opposite directions on a linked cable.
Witnesses reported seeing one of the carriages hurtle down the hill before derailing and crashing 30m from the bottom.
The aftermath shows it crumpled and twisted against the side of a building.
People who were in the bottom carriage said they were a few metres into the climb when it started going backwards.
When they saw the other car speeding towards them, many jumped through the windows to escape.
Image: The crash happened around 6pm on Wednesday. Pic: Reuters
Prime Minister Luis Montenegro called the crash “one of the biggest tragedies of our recent past” and authorities are under intense pressure to quickly identifying the cause.
Nigel Farage has confirmed he wants to deport women asylum seekers back to the Taliban in Afghanistan if he becomes prime minister.
The Reform UK leader’s position on the topic has not been clear, with him previously saying he wouldn’t send women back to the fundamentalist regime that took over after western militaries withdrew, before now saying he would.
Mr Farage was speaking to Sky News’ political editor Beth Rigby at the Reform UK party conference in Birmingham.
When asked if he would “detain” women and children and “send them back”, the Clacton MP said “yes”.
Challenged on when he said in August that he was not “discussing” women and children, Mr Farage claimed this was a reference to his desire to see men detained on arrival in the UK.
At the time, he said he was “very, very clear” on the “deportation of illegal immigrants”, adding: “We are not even discussing women and children at this stage – there are so many illegal males in Britain, and the news reports that said that after my conference yesterday were wrong”.
Speaking today, Mr Farage claimed that the UK has a “duty of care” to a child if, for example, a four-year-old arrives in a dinghy – but not to women and men.
“For clarity, those that cross the English Channel will be detained and deported, men and women,” Mr Farage went on.
Image: Nigel Farage speaks to Beth Rigby at Reform’s 2025 conference
‘No one’ can prevent small boats crossing the Channel
The Reform leader also rowed back on his pledge to stop all boats within two weeks if he is elected prime minister.
Speaking to the conference yesterday, Mr Farage said: “You cannot come here illegally and stay – we will stop the boats within two weeks of winning government.”
But speaking to Beth Rigby today, he changed tack – saying “the passing of legislation” would be required.
He said only then would the boats be stopped within two weeks, or sooner In the interview with Rigby, Mr Farage tried to claim he did not say he would end the boats within two weeks of “winning government”.
But the video of his speech, as well as the transcript released by Reform UK, clearly show him saying: “We will stop the boats within two weeks of winning government.”
When asked why he wouldn’t be able to follow through with his initial claim, Mr Farage said it was impossible and that “no one” can prevent them crossing the Channel.
The Reform UK leader said the law he wants to introduce will be called the Illegal Migration Act once it is passed by parliament.
He confirmed his agenda includes leaving the European Convention on Human Rights, shutting down asylum hotels and housing people at RAF bases instead, as well as deporting Channel migrants.
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Mr Farage also claimed that deportation flights would also begin within two weeks of the law changing, and this combination of factors would stop people from wanting to travel from France.
Reform doesn’t seem bothered about detail amongst their fireworks
Nigel Farage insists his policy on mass deportations is clear when it comes to women and girls.
But I’ve watched every Reform speech since they unveiled their flagship policy – and I was there in the room to ask him when he announced what he will do with women and children who come here via small boats if he was in power – and I still can’t work it out.
That’s because he’s said three different things since, including in an interview today.
Originally he said everyone would be detained: “Yes, women and children, everybody on arrival will be detained. And I’ve accepted already that how we deal with children is a much more complicated and difficult issue.”
A day later he said Reform is “not even discussing women and children at this stage” implying women and children would not be deported.
He also said it was “not true” that’s he had committed to sending women and girls back to countries where they can be raped, tortured and killed.
But today at their conference he told Sky News that women who arrive by boat will be deported to Afghanistan “if necessary”.
Considering Reform UK say they are willing to make deals with Afghanistan and Syria, this question is an important one. The UK has not recognised the Taliban as a legitimate government of Afghanistan since the group seized Kabul in 2021 and first established a regime based on an extreme interpretation of Islamic law.
Reform’s deputy leader Richard Tice has defended those plans, saying: “Sometimes you do deals with people you may not want to go down the pub with.”
Farage clarified that “children, of course, we’ll have to know that we’re sending them off somewhere sensible”.
He has also previously said asylum seekers were a threat to national security and to British women.
The broader political issue though, is that Reform’s immigration plan was meant to be a detailed and considered policy on an issue they’ve been ahead of other politicians on for years.
So why aren’t they more forthcoming with their answers on what they would do with women and children?
If they had hoped to truly embody their conference slogan of “next steps” to professionalise the party, they need to urgently address this.
But party members here don’t seem to be bothered by this detail amongst the fireworks, the enthusiasm and the energy here.
It turns out that years of banging on about this single issue for decades is Nigel Farage’s greatest strength – and the public are willing to give him the grace to work out the details later down the line.
This strategy all depends on Reform UK winning the next general election – which Labour does not have to call until 2029.
However, the Reform leader says he believes the government will collapse in 2027 due to economic pressure and other factors.
Reform are currently well clear of Labour and the Conservatives in the polling, and are targeting next year’s Welsh, Scottish and English local elections to try and win more power in councils and national assemblies.
Clashes have broken out at a protest for Palestine Action in London as police reveal they have made around 150 arrests.
The Metropolitan Police said officers had been “subjected to an exceptional level of abuse” at the Westminster protest, including “punches, kicks, spitting and objects being thrown”.
It added some protesters had been both physically and verbally abusive in a “coordinated effort to prevent officers carrying out their duties”, and that a number of the arrests were made for assault.
Officers were seen drawing their batons while demonstrators took action in support of the proscribed terror organisation.
One man was seen with blood streaming down his face behind a barrier after being arrested, while the crowd was heard chanting “shame on you” and “you’re supporting genocide”.
Image: Pic: PA
Image: Pic: PA
Tense scenes on the western side of Parliament Square saw several protesters fall over in a crush while water was thrown at officers.
The Met Police announced the first arrests of the day on X just 12 minutes after the protest’s official start time.
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Watch moment police carry several protesters away
The protest’s organiser, Defend Our Juries, said it estimated 1,500 had gathered for the rally, where many of them held signs saying: “I oppose genocide. I support Palestine Action.”
In an update early on Saturday evening, the Met said: “Any assaults against officers will not be tolerated and arrests have already been made. We will identify all those responsible and prosecute to the full extent of the law.”
It had warned before the protest that “expressing support for a proscribed organisation is a criminal offence under the Terrorism Act”.
“Where our officers see offences, we will make arrests,” it said.
Image: A protester is carried away by police in Parliament Square. Pic: PA
Image: Pic: PA
A spokesperson for Defend Our Juries claimed the rally had been “the picture of peaceful protest” and that the Met Police’s statement about its officers being abused was an “astonishing claim”.
“I’ve been here all day and I haven’t seen any violence or aggression from anyone,” they said. “I’ve only seen aggression and violence from the police.”
Palestine Action has been banned as a terror group since 5 July after MPs voted overwhelmingly in favour of the move proposed by then-home secretary Yvette Cooper, making it illegal to express support for the group.
The ban on the group came shortly after two Voyager aircraft suffered around £7m worth of damage at RAF Brize Norton in Oxfordshire on 20 June.
More than 530 people were arrested at the last major demonstration against Palestine Action being banned as a terror group. However, the Met Police used “street bail” to avoid having to process them all in custody.
Street bail allows officers to release suspects on bail before they are taken to a police station. The suspect receives a bail notice requiring them to return to a station at a future date instead.
The organisers encouraged protesters not to accept street bail during today’s demonstration, writing in a briefing document before they started: “It will not be practically possible for the police to arrest 1,000 non-compliant people on the same day, and that is the strategic rationale behind non-compliance. It increases pressure on the state.”
In a reference to the advice in the briefing document, a Metropolitan Police spokesperson told Sky News the move would be “misguided”.
It faces a legal challenge in November after the High Court granted a full judicial review to Palestine Action co-founder Huda Ammori.