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”.
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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.
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.”
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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.
Footage of the moment 10-year-old Sara Sharif’s alleged killers were detained after police boarded their plane back to the UK has been played in court.
As they are approached by officers, Sara‘sstepmother Beinash Batool is heard saying: “I think you’re looking for us.”
Batool, 30, Sara’s father Urfan Sharif, 42, and uncle Faisal Malik, 29, are accused of carrying out a campaign of abuse against her culminating in her death at her family home in Surreyon 8 August last year.
The defendants, along with five of Sara’s siblings, aged between one and 13, flew to Pakistanthe following day.
Sara’s body was found by police in a bunkbed on 10 August after Sharif called police from Pakistan to say he had beaten her “too much” for being “naughty”.
A murder investigation was launched involving agencies including Interpol and the National Crime Agency to locate the defendants.
More on Sara Sharif
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They returned to the UK on a flight from Dubai to Gatwick Airport on 13 September.
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‘I beat her up too much’
The clips of officers’ body-worn video shown to the jury on Friday captured the moment police boarded the plane and detained the defendants at 7.42pm, seven minutes after touchdown.
After Batool addresses the officers, Sharif, who had been sitting next to her, is asked to follow them.
The three were then taken off the plane and arrested.
A post-mortem examination established Sara had sustained extensive and significant injuries over a sustained period prior to her death.
The jury heard on Friday how concerns were raised by Sara’s school about bruising on her body in June 2022 and March 2023.
Several items seized from Sara’s home were also reviewed by the court, including a leather belt which had full DNA samples at both ends for Sara, Sharif, and Malik.
A cricket bat was also found to have Sara’s DNA profile on it, along with the DNA samples of Sharif and Malik.
Neither item had a DNA trace of Batool.
The court also reviewed the defendants’ bank accounts – both joint and separate.
All three defendants have pleaded not guilty to murder and causing or allowing the death of a child.
Six teenagers have been arrested after a 13-year-old girl was found with multiple stab wounds on a roadside near Hull.
Police said she was found around 6.50am on the A63 in Hessle with “life-threatening injuries” including “lacerations to her neck, abdomen, chest and back”.
Four boys and two girls – aged between 14 and 17 – were quickly arrested in a nearby wooded area and are being questioned on suspicion of attempted murder.
Members of the public came to the girl’s aid before emergency services arrived, Humberside Police said.
Detective Superintendent Simon Vickers said they “believe the attackers knew the victim” and the circumstances are still being investigated.
“The girl remains in hospital in critical condition and her family are being supported by officers at this difficult time,” he added.
The boys arrested are aged 14, 15, 16 and 17, and the girls 14 and 15.
Cordons are in place around a wooded area off Ferriby High Road while investigations continue.
Police said they would have an increased presence in the area over the weekend and have asked anyone with information or video to get in touch, or contact Crimestoppers anonymously.
A former soldier has told a jury his escape from Wandsworth prison to avoid being held with sex offenders and terrorists showed his “skillset”.
Daniel Khalife, 23, who was being held accused of passing secrets to Iran said he was “never a real spy” but planned a fake defection to the state following his arrest after watching American television show Homeland.
He said he wanted to be moved to a high-security unit because he was getting unwanted attention from the sex offenders on the vulnerable prisoners wing and feared a move to Belmarsh prison because, as a British soldier, terrorists wanted to kill him.
Khalife said he first wanted to “make a show” of escaping, acting suspiciously and covering himself in soot from a food delivery lorry on 21 August last year, while he was working in the prison kitchen.
He was spotted and reported to security but was “pretty shocked” when nothing happened so decided to take the “full measure,” he told the jury.
Talking about his escape for the first time at his Woolwich Crown Court trial, Khalife told how he fashioned a makeshift sling from kitchen trousers and carabiners used by inmates to keep their possessions safe from rats.
He attached it to the Bidfood lorry on 1 September last year, to see if it would be spotted by officers at Wandsworth or other prisons on the delivery route.
“I put the two carabiners and the makeshift rope underneath the lorry,” he said.
“When I had made the decision to actually leave the prison I was going to do it properly so I tested the security not just in Wandsworth
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“Strangely, over the coming days, I could see it but it wasn’t spotted in Wandsworth or any other prison.”
Then on the morning of 6 September, Khalife said he concealed himself underneath the lorry, resting his back on the sling as the lorry was searched.
“They did normal checks around with torches but they didn’t find me. After that, a governor came to the tunnel and said, ‘Have you searched the vehicle?’
“I was facing upwards. There was action around the lorry.”
He said that when the vehicle stopped he “came out underneath the lorry and stayed in the prone position” until the lorry moved off.
Khalife, who joined the Army aged 16 and took up a post with the Royal Signals, based in Beacons barracks, Staffordshire, said he made no attempt to leave the country and had no intention to “run away” from the charges he was facing.
He was arrested three days later on the footpath of the Grand Union Canal in Northolt, west London, after a nationwide manhunt.
Asked why he had not handed himself in after his escape, Khalife said: “I was finally demonstrating what a foolish idea it was to have someone of my skillset in prison. What use was that to anyone?”
“I accept that I left the prison and didn’t have any permission to do so,” he said. “I accept absolutely that I shouldn’t have done what I did.”
Inspired by Homeland
The court has heard Khalife initiated contact with Iranian intelligence officers after he was told he could not pass developed vetting because his mother was born in Iran.
Khalife told MI5 he wanted to be a “double agent” and he said in court he thought he would be “congratulated” but described his arrest as like a “punch in the face”.
Wearing a blue checked shirt and chinos, he said police were “blinded at the prospect of a successful prosecution” but he did not think being in prison would be in “the public interest”.
“I didn’t do anything that harmed our national security. I wanted to put myself in a position where I could help my country,” he said.
“I believed I could continue my work actually located in the state – the state being Iran.”
Khalife said he took inspiration from watching Homeland, starring Claire Danes and Damian Lewis, in which Americans and terrorists go undercover, on Netflix.
“I had seen one of the characters in the programme had actually falsely defected to a particular country and utilised that position to further the national security interests of that character’s country,” he said.
“The country in question, Iran, thought it was real. She did it to further the interests of her own country.”
Khalife told jurors he is a “patriot”, adding: “I do love my country. All I wanted to do was help. I never wanted to do any harm, I never did do any harm.”
He added: “It is tragic it has come to this and I would do anything to go back to my career.”
Khalife, from Kingston, southwest London, denies a charge of committing an act prejudicial to the safety or interests of the state under the Official Secrets Act between 1 May 2019 and 6 January 2022.
He has also pleaded not guilty to a charge under the Terrorism Act of eliciting information about Armed Forces personnel on 2 August 2021, perpetrating a bomb hoax on or before 2 January 2023 and escaping from prison on 6 September last year.