Ambulance workers go on strike today – with NHS offering advice on how patients will be affected
About 25,000 ambulance workers across England and Wales will strike today in a dispute with the government over pay, amid fears some patients will be forced to make their own way to hospital.
Staggered walkouts will take place over a 24-hour period and will include paramedics, call handlers, drivers and technicians from the Unison and GMB unions.
Workers will not strike for longer than 12 hours each, with call handlers expected to walk out for six-hour periods.
Staff working at the LAS emergency operations centre in Newham, east London, ahead of Wednesday’s strikes
Patients can expect waits for 999 and 111 calls to be answered as well as delays for ambulances, with health leaders warning of additional stress on an NHS that’s already under pressure.
Unison has balloted some 15,000 of its members who are set to walk out in London, Yorkshire, the North West, North East and South West.
Meanwhile, more than 10,000 GMB ambulance workers are also expected to strike, meaning ambulance services will be affected in the South West, South East coast, North West, South Central area, North East, East Midlands, West Midlands, Yorkshire and Wales.
NHS England has advised patients to continue to call 999 for life-threatening emergencies but to use 111, GPs and pharmacies for non-urgent needs.
It said some people may be asked to make their own way to hospital, but urged people to seek medical advice from 111 or 999 before doing so.
If you are an NHS worker and would like to share your experiences with us anonymously, please email NHSstories@sky.uk
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Health workers daily ‘firefight’
‘Unwelcome return to unnecessary disruption’
Health and Social Care Secretary Steve Barclay said: “Today’s ambulance strike is an unwelcome return to unnecessary disruption and comes at a time when the NHS is already under huge pressure from COVID and flu.
“While we have contingency plans in place, including support from the military, community first responders and extra call handlers, to mitigate risks to patient safety, there will inevitably be some disruption for patients with fewer ambulances on the road.”
Ambulance responses are split into categories, with category one being the most life-threatening such as cardiac arrests, while category two covers conditions such as strokes and sepsis.
Unions and trusts will decide which category two calls will receive a response during the strike.
The West Midlands Ambulance Service said it had agreed on a response to all category one calls plus other life-threatening cases such as heart attacks, strokes, difficulty in breathing and maternity cases.
Ben Holdaway, director of operations at the East Midlands Ambulance Service, said teams have worked to maximise the number of staff, though he anticipated a “much slower” response than usual.
“Where possible, our 999 control rooms will carefully assess and prioritise an ambulance response for those who need it most, and this may only be where there is a threat to life,” he added.
South Central Ambulance Service said the strike will involve 200 workers and will mostly disrupt its non-emergency patient transport services.
Meanwhile, Yorkshire Ambulance Service warned all its services will be impacted – including frontline emergency ambulances and 999 call handling, non-emergency patient transport and NHS 111.
It said ambulances will still be able to respond during the strike, “but this will only be where there is an immediate risk to life”.
In London, there is an agreement in place that a maximum of 50% of the staff will be taking industrial action at any one time and staff will come off picket lines if call-answering times are too long, according to Daniel Elkeles, the service’s chief executive officer.
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Who is striking and when?
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Why is the NHS struggling so much?
‘Life and limb conditions’
On whether category two calls will be answered, he said: “They will. We have called it life and limb conditions because some of them are in category one, some of them are in category two, and actually, some might be in category three.”
Miriam Deakin, director of policy and strategy at NHS Providers, said trust leaders feared the NHS will be hit harder by Wednesday’s strike as more staff strike than they did in December, but said they will “pull out all the stops” to minimise the impact.
Monday’s talks between unions and the government failed to stop the planned strike, with industrial action also in the pipeline by teachers and rail staff.
Nurses are planning to strike next Wednesday and Thursday, while another ambulance strike is set to take place on 23 January.
Ambulance workers on the picket line outside Soundwell Ambulance Station, Bristol, in December
On Tuesday, the government brought in new legislation for “minimum safety levels” when workers stage walkouts.
But Business Secretary Grant Shapps told the Commons that Wednesday’s ambulance strike “still does not have minimum safety levels in place and this will result in patchy emergency care for the British people”.
Ambulance workers in England and Wales are striking over demands for a pay rise above inflation, but the government says most ambulance staff have received a pay rise of at least 4%.
Health Secretary Steven Barclay will be interviewed on Sky News at 7.20am.
Ramesh lives in fear every day. A police siren is enough to alarm him.
He’s one of up to 400,000 visa overstayers in the UK, one lawyer we spoke to believes.
It’s only an estimate because the Home Office has stopped collecting figures – which were unreliable in the first place.
Britain is being laughed at, one man told us, “because they know it’s a soft country”.
‘Ramesh’ came to the UK from India
We meet Ramesh (not his real name) at a Gurdwara, a Sikh place of worship, where he goes for food and support.
He insists he can’t return to India where he claims he was involved in political activism.
Ramesh says he came to the UK on a student visa in 2023, but it was cancelled when he failed to continue his studies after being involved in a serious accident.
He tells us he is doing cash-in-hand work for people who he knows through the community where he is living and is currently working on a house extension where he gets paid as little as £50 for nine hours labouring.
“It’s very difficult for me to live in the UK without my Indian or Pakistani community – also because there are a lot of Pakistani people who give me work in their houses for cleaning and for household things,” he adds.
‘What will become of people like us?’
Anike has lived in limbo for 12 years.
Now living in Greater Manchester, she came to the UK from Nigeria when her sister Esther was diagnosed with a brain tumour – she had a multi-entry visa but was supposed to leave after three months.
Esther had serious complications from brain surgery and says she is reliant on her sister for care.
Immigration officials are in touch with her because she has to digitally sign in every month.
Anike has had seven failed applications for leave to remain on compassionate grounds refused but is now desperate to have her status settled – afraid of the shifting public mood over migration.
“Everybody is thinking ‘what will become of people like us?'” she adds.
‘It’s a shambles’
The government can’t say with any degree of accuracy how many visa overstayers there are in Britain – no data has been collated for five-and-a-half years.
But piecing together multiple accounts from community leaders and lawyers the picture we’ve built is stark.
Immigration lawyer Harjap Singh Bhangal told us he believed there could be several hundred thousand visa overstayers currently in Britain.
He says: “At this time, there’s definitely in excess of about 200,000 people overstaying in the UK. It might even be closer to 300,000, it could even be 400,000.”
Asked what evidence he has for this he replies: “Every day I see at least one overstayer, any immigration lawyers like me see overstayers and that is the bulk of the work for immigration lawyers.
“The Home Office doesn’t have any accurate data because we don’t have exit controls. It’s a shambles. It’s an institution where every wall in the building is cracked.”
The number of those who are overstaying visas and working cash in hand is also virtually impossible to measure.
‘They know Britain is a soft country’
“They’re laughing at us because they know Britain is a soft country, where you won’t be picked up easily,” says the local man we’ve arranged to meet as part of our investigation.
We’re in Kingsbury in northwest London – an area which people say has been transformed over the past five years as post-Brexit visa opportunities opened up for people coming from South Asia.
‘Mini-Mumbai’
The man we’re talking to lives in the community and helps with events here. He doesn’t want to be identified but raises serious questions about visa abuse.
“Since the last five years, a huge amount of people have come in this country on this visiting visa, and they come with one thing in mind – to overstay and work in cash,” he says.
“This area is easy to live in because they know they can survive. It looks like as if you are walking through mini-Mumbai.”
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‘The system is more than broken’
‘It’s taxpayers who are paying’
And he claims economic migrants are regularly arriving – who’ve paid strangers to pretend they’re a friend or relative in order to obtain a visitor visa to get to Britain.
He says: “I’ve come across so many people who have come this way into this country. It’s widespread. When I talk to these people, they literally tell me, ‘Oh, someone is coming tomorrow, day after tomorrow, someone is coming’.
“Because they’re hidden they may not be claiming benefits, but they can access emergency healthcare and their children can go to school.
“And who is paying for it? It’s the taxpayers who are paying for all this,” says the man we’ve met in north London.
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A Home Office spokesperson said: “We will not tolerate any abuse of our immigration system and anyone found to be breaking the rules will be liable to have enforcement action taken against them.
“In the first year of this government, we have returned 35,000 people with no right to be here – a 13% rise compared to the previous year.
“Arrests and raids for illegal working have soared to their highest levels since records began, up 63% and 51%.”
The government can’t say with accuracy how many visa overstayers there are in Britain – no data has been collated for five-and-a-half years.
Sky News has spoken to immigration lawyers about the numbers, and one believes there could be as many as 400,000 living across the country.
Harjap Singh Bhangal described the situation as a “shambles”.
“The Home Office doesn’t have any accurate data because we don’t have exit controls. It’s a shambles. It’s an institution where every wall in the building is cracked,” he told Sky’s Lisa Holland.
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The visa overstayers in ‘soft’ Britain
Why doesn’t the government know?
The Home Office used to gather data on visa overstayers by effectively checking a list of passport numbers associated with visas against a list of passport numbers of people leaving the UK, taken from airlines and other international travel providers.
If there was a passport number match in the arrivals and departures part of their database, that person was recorded to have left when they should have. If there wasn’t, they were a potential overstayer.
They stopped producing the figures because a combination of Brexit and COVID added complications that made the Home Office conclude they wouldn’t be able to get to a reliable number using the same method.
It’s now four and a half years since EU citizens had freedom of movement to the UK revoked, and more than three and a half years since pandemic-era travel restrictions ended.
And yet we are still waiting to see what a new method might look like.
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The old method wasn’t perfect. If someone changed their passport while in the UK, for example, or if the airline or individual entered the number wrong when they were leaving, there wouldn’t be a match.
The Home Office regarded the statistics as likely overestimating the true number of overstayers, and the Office for National Statistics designated the figures as “experimental” rather than “official” statistics, meaning the conclusions should be treated with caution. But they were a reasonable best guess.
With all that in mind, between April 2016 and March 2020 upwards of 250,000 people were flagged as potential overstayers, equivalent to 63,000 per year.
That’s more than the 190,000 people who are recorded to have arrived in the UK on small boats since 2018.
It represents 3.5% of the seven million visas that expired over that period, so at least 96.5% of people left when they should.
Other Home Office data reveals that more than 13 million visas were issued between 2020 and the end of June 2025, including a record 3.4 million in 2023.
But what we don’t know is how many have expired, which means it’s difficult for us to even guess how many people might have overstayed.
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