Hospitals urged to free up beds ahead of ambulance crew strikes

Healthcare officials have urged hospitals to prepare urgently for the strikes which they fear will have an even greater impact than the nurse walkouts, explains Sejal Karia.

Health chiefs have urged hospitals to free up a maximum number of beds by safely discharging patients ahead of industrial action by ambulance crews.

Sir David Sloman, NHS England’s chief operating officer, warned of “extensive disruption” during what would be “a very challenging period”.

Ambulance crews in England and Wales are due to walk out for two days on December 21 and 28 in a dispute over pay and staffing levels.

It comes after around 100,000 nurses took to picket lines around the UK on Thursday in what has become the biggest ever strike in the history of the NHS.

The Police Federation has already suggested police officers may be called upon to drive ambulances, while the government said it may also ask the army and even taxi drivers to step in.

But NHS bosses are worried this strike could have a more significant impact than the nurses' walkout and have ordered hospitals to prepare urgently.

Suggestions include discharging medically fit patients from acute, mental health, and community trusts as soon as possible to free up beds, and postponing some outpatient appointments in order for senior A&E doctors to be redeployed to A&E departments.

Measures should also be put in place to ensure ambulance patient handovers are kept to no more than 15 minutes, Sir David said in a joint letter with national medical director Professor Sir Stephen Powis and chief nursing officer Dame Ruth May to NHS trusts and integrated care boards (ICBs).

But unions representing A&E doctors said the suggestion will be difficult to execute, as they have been attempting for three years to free up more beds and get ambulances back on the frontline.

NHS data on Thursday showed ambulance handover delays at hospitals in England had hit a new high, with one in six patients last week waiting more than a hour to be passed to A&E teams.

Just over one in three had to wait at least 30 minutes. The numbers are higher than at any point in recent winters.

NHS Providers’ interim chief executive Saffron Cordery said in response: “Trust and system leaders are being asked by NHS England to focus on reducing handover delays and maximising capacity in urgent and emergency care.

“But given the scale of operational pressures on providers now including very high bed occupancy levels, rising flu admissions, ongoing Covid-19 pressures, record staff absences and increasing A&E attendances, this will be incredibly difficult to implement.”

She added: “We understand why ambulance staff have voted for industrial action but it’s vital that the Government and unions talk urgently to find a way to prevent this and further strikes from happening.”

Setting out “three essential actions” to “ensure the safety of patients and staff”, the letter asked for confirmation of “system-level operational plans” for ambulance strike days with NHS England regional teams by a deadline of 4pm on December 19.

The plans would allow for additional support to be considered and arranged, it said.

Grant Shapps said the government will say more on plans to legislate for minimum service levels during industrial action in the new year, as he defended its approach to the public sector pay dispute as “fair and proper”.

He said people will “all end up much worse off” if ministers award inflation-busting pay rises.

Asked if it is true ministers are dropping proposals to extend the rules affecting transport workers to ambulance staff and firefighters, he told BBC Radio 4’s Today programme: “We’ll say more about the minimum service levels and other measures in the new year.

“One thing I do think is right is that obviously people should have the right to strike. I completely understand that and I think that’s right.

“People should also have the right, though, to be able to go about their lives. And some of the people who are impacted most by strikes, particularly on the railways, are not people who can sit at home, perhaps behind their computer and work from home, but the hospital porter, the cleaner, who has to physically go to work.

“So I think there are rights for other workers as well.”

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Nine ambulance trusts in England are expected to be affected by industrial action, co-ordinated by the GMB, Unison and Unite, on December 21 and eight ambulance trusts affected on December 28.

Advice from the health chiefs also included the prospect of creating “observation areas and additional beds” elsewhere in hospitals.

They also asked for “steps to allow moving of patients who have completed their emergency medical care and are awaiting an inpatient bed out of the ED to create space for new patients”.

“This may involve the creation of observation areas and additional beds elsewhere in the hospital.”

The letter added: “Thank you for everything you have been doing to prepare to ensure that patients are kept as safe as possible and that services are maintained as effectively as possible over what will be a very challenging period.

“Derogation discussions with trade unions are ongoing at a local level, therefore the impact upon services will vary across different ambulance services, but extensive disruption is expected.”