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Rail strikes ‘will kill people’, warns NHS leader

Published on: 17 Jun 2022

Next week’s rail strikes will ’probably end up killing people’ as they will prevent staff working for already struggling ambulance trusts from getting to work, a senior NHS leader has told HSJ.

Both London Ambulance Service Trust and South Central Ambulance Service Foundation Trust have moved to ”Reap 4”, This is the highest level of alert, meaning they are under extreme pressure. 

Ambulance trusts are already experiencing high demand amid soaring temperatures and continuing problems with lengthy handovers at the accident and emergency departments. Fears are now growing that next week’s rail strikes will push services to breaking point as many ambulance staff travel to work by public transport.

The three days of rail strikes – on Tuesday, Thursday and Saturday next week – will see many lines with very limited services. Tube services in London will also be hit by a strike on Tuesday and the London Overground and some tube lines will be affected on rail strike days. A level three heat warning is in place for London, the East of England and the South East, with lower level warnings for other parts of the country.

A senior leader closely involved in southern England’s emergency and urgent care services told HSJ: “Next week’s rail strikes will probably end up killing people because they’ll prevent ambulance trust staff getting to work.”

Other ambulance trusts are understood to be monitoring the situation closely. Trusts in REAP 4 (REAP stands for resource escalation action plan) normally take a series of measures including diverting more staff to frontline duties, asking some patients to make their own way to hospital and concentrating on reaching the most serious patients.

A London Ambulance Service spokesperson said: ”As a result of a significant increase in demand on both our 999 and 111 services, and with warm weather set to continue over the next few days, we have taken the decision to move up to Reap 4 – which represents ‘extreme pressure’ – with immediate effect. It also allows us to be prepared for the proposed national rail strike next week.”

Most ambulance trusts were at REAP 4 in the early part of the year but have been able to reduce that in the last few months – allowing activities such as routine training to recommence. However, some – such as East of England Ambulance Service FT – have remained in REAP 4.

Some acute trusts are also experiencing very high numbers of patients at A&E. Frimley Health FT has asked patients to consider alternatives after volumes at both its main sites – Wexham Park in Slough and Frimley Park – increased.

The trust’s new electronic patient record went live last weekend at a time when the trust expected relatively low levels of demand. The new EPR is said to be working well but the trust had anticipated its teams would work slightly slower than usual in the go-live period.

The Royal College of Emergency Medcine also pointed to the pressure on hospitals in the south east last month when A&E attendances were 8.5 per cent higher than the previous month with one third of patients waiting more than four hours to be admiited, transferred or discharged. 

“In the south east we need acknowledgement of the pressure the system is under, we need local members of parliament, local councils and local authorities to recognise the strain and we need these groups to advocate for health care workers who are continuously pushed to the brink,” said Dr Salwa Malik, consultant in emergency nedicine and regional chair for the RCEM. 


The RMT rail union has been asked for comment .

 Updated 14:16 to clarify strike days and add in RCEM quote and 15:36 to add in LAS comment