More than 300 clinicians are being sought from primary care to help London Ambulance Service during next week’s strike, according to a letter seen by HSJ, amid fears it will have a greater impact than last month’s industrial action.
A request from the service, passed on to primary care staff in the capital, urgently requested clinical support ahead of a strike by Unison and GMB staff on 11 January.
The note, sent on behalf of NHS England by a London ICS, says: “The early indication from national Unison is that the categories of employees called out on 11 January 2023 will be greater this time, including control rooms and support staff.”
The letter shows each London integrated care system has been asked to provider dozens of “experienced doctors and nurses who have current acute, urgent or emergency clinical exposure” to “operate as a senior clinical decision maker”; and also 30 clinicians to be part of “contingency ambulance crews… to operate the vehicle and provide basic first aid”.
Robust triage and “hear and treat” advice to 999 callers played a big part in dealing with demand despite reduced crews on 21 December, and several ambulance trusts are expecting more staff from their ambulance control rooms, also known as emergency operations centres, to walk out this month, as well as patient transport services.
Unison has said its two January strike days (11 and 23 January) are an “escalation” of last month’s as they “will each be for 24 hours, from midnight to midnight, and involve all ambulance employees, not just the 999 response crews”.
Several senior leaders in ambulance trusts told HSJ it was proving easier to agree derogations (exceptions) from the strike action than it did in December – with some carried over, and early agreements on a basic level of control room staffing.
However, they said they were very worried the overall impact could be worse because public demand would not dip as steeply as it did on 21 December, and other parts of the system – already under intense pressure – may be less able to help, by cutting handover delays.
An ambulance service source in the south of England said: “There is a lot of anxiety. Hospitals are really struggling and we were very much helped last time by a 30 per cent reduction in demand.
“We had support from the Army and threw everything we could at it. But if demand had been at normal levels, we would have been stuffed.”
Another ambulance service official said: “I am worried about how the rest of the system can respond. It felt last time that the hospitals had had a clearout, but they are not in the same position as they were last time.”
Hours and regions covered
Unison has indicated its staff will strike for 24 hours on 11 January, up from 12 hours on 21 December. However, there appears to be some regional variation, with one area stating it is expecting another 12-hour walkout.
One trust official said GMB was also planning to strike for more hours but the exact plans for coverage are unclear.
The unions striking at each trust next week are set out in the table below. However, Unison has said it will reballot members in other providers with a view to securing a mandate to strike at more trusts later in the year. It is unclear whether this could take effect as soon as late January, February, or not until the spring.