How will North West Ambulance walk outs impact patients and why are they striking?
ITV Granada Reports journalist Jennifer Buck takes a look to see if there any hope that last ditch talks will avert the walkouts.
Ambulance workers in the North West are set to walk out over pay on Wednesday 21 December.
It is the first of two days of strike action while paramedics, emergency care assistants, call handlers and other staff will also walk out on 28 December.
While there are some plans to mitigate its impact, it is likely to have a knock on effect on the North West.
What to expect from the strikes
A letter from North West Ambulance Service (NWAS) outlines how they expect the industrial action to impact their facilities.
The North West Ambulance serviced are planning for 72 hours of disruption
Available ambulance staff will focus on life-threatening illnesses or injuries
There will be no senior clinicians in the control rooms
There will be no patient transfer between hospitals - there will be some consideration to use volunteers drivers, taxis and private ambulances
NWAS says during the strike, "confirmed" cases of cardiac arrests and "immediate threats to life" would continue to attract an ambulance response, but if A&E attendance is required "immediate self-conveyance or taxi conveyance will be advised in all other circumstances".
Paramedics will also attend confirmed maternity emergencies but similar advice has been issued ‘in all other circumstances’.
On the day of strike action, NWAS’ Patient Transport Service will only prioritise patients attending cancer, renal and palliative care appointments.
Who is striking?
Paramedics, emergency care assistants, call handlers and other staff will all be walking out as part of the dispute.
Why are they striking?
Workers across the ambulance services and some NHS trusts have voted to strike over the government’s 4% pay award, which the GMB union described as another "massive real-terms pay cut".
These strikes also follow industrial action from the Royal College of Nursing on Tuesday 20 December.
What to do if I have an emergency and what are the government doing to help?
The public are still being urged to ring 999 if they or someone they know requires urgent medical attention.
The Cabinet Office said about 2,000 military personnel, civil servants and other volunteers from across government have been training as part of its contingency planning.
The government say they are open to talks with the unions and want to resolve the dispute
They included up to 600 armed forces personnel and 700 staff from the government’s specialist Surge and Rapid Response Team, as well as from other parts of the Civil Service.
The non-emergency NHS 111 hotline is still available for advice.
The government has said urgent 999 patients could be taken to A&E during the strikes in taxis.
Patients who fall into categories three and four - conditions that are not immediately life-threatening such as an uncomplicated diabetic issue - who may otherwise need an ambulance could be driven in a cab.
GP surgeries remain open as normal.
Another cobra meeting is scheduled for Wednesday 21 December to discuss the issue.
What have NWAS said?
Ged Blezard, Director of Operations, said: “We have tried and tested plans to manage any disruption, including industrial action, however, it’s important to understand there will be an impact on the public.
"We want you to continue to ring 999 in a situation where there is an immediate threat to life.
"We are advising patients, that they should consider other forms of transport if they still need to go to a hospital.
“We are maximising our own resources, using private provider and military support where appropriate and working closely with our trade unions to provide cover for the most serious emergencies.
"We are also working with our healthcare partners to maintain patient safety during these periods of industrial action.
“Also, if you have already called 999 to request an ambulance, please only call back if your condition has worsened or to cancel the ambulance.
"Repeatedly calling 999 can block phone lines for other emergencies. If you need urgent care – use the symptom checker at NHS 111 online, which will direct you to the most appropriate support.
"Again, you should call on friends or relatives for transport if necessary.”
Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To Know