A striking ambulance worker dressed as Father Christmas joined picket in Manchester

Video report by ITV Granada Reports correspondent Ann O'Connor

An ambulance worker, dressed as Father Christmas joined colleagues on the picket line in Manchester in a dispute over pay and staff shortages.

Steve McDonnell, an emergency medical technician (EMT) with North West Ambulance Service said he'd had to turn to food banks recently and it was a ‘difficult decision’ to be there as he ‘cannot afford to strike’.

With the latest strike affecting health workers, Health Minister Will Quince MP gave the unusual advice of asking people to avoid unnecessary journeys, risky activities and "contact sport" as vital services were being disrupted by the dispute over pay.

The Health Secretary Stephen Barclay also accused trade unions of making a "conscious decision" to "inflict harm" on patients.

In response, ambulance workers say the national walkout isn't just about money but also about protecting a crumbling NHS.

At the Me2 dementia day care centre in Kirkby on Merseyside set up by a former nurse, staff say they are worried because they care for vulnerable patients.

But they also know the strain on the service poses risks all year round.

Former nurse, Rosemarie Whittington says the day before the strike she called for an ambulance for one of their residents and there was a 4 hour wait. Staff were forced to take the resident to A&E themselves.

She said, "It's not just today when there are worries around ambulances, it's everyday and that's for a multitude of reasons, because basically the NHS is on its knees."

The strikes comes as figures show A&E waits and ambulance response times have hit their worse levels on record.

The north west is among the hardest hit area, as a result of three trades union taking action together.

Hospitals advise people to only ring 999 if there is an immediate threat to life.

A number of contingency plans are in operation including the use of some Army drivers but most patients will need to find their own transport if they need to go to hospital.

There's another walkout planned in the row over pay next week unless negotiations resume.

Donning a Santa costume on the picket line at Manchester Central Ambulance Station, Steve McDonnell, joined colleagues even though he said he cannot afford to lose money.

Jeff Gorman, an EMT in Manchester said the strike was about more than just money.

It was also about the state of the NHS and patient care. He said, "You get to the house - they might have been waiting four or five hours for the ambulance to arrive."

"You get to the hospital - you are sat in the back of the ambulance with the patient - it can be four, five, ten hours at a time. You watch that patient deteriorate. It is heartbreaking."

Dr Chris Grant from North West Ambulance Service said: "We're using all our available resources.:

"We're working with our voluntary services. We're working with the private ambulance services. We've got military colleagues joining us."

"So we'll use everyone available to us to protect the public across the North West."

Sarah Gorton from Unison said: "Every single day health workers are making compromises - not only because of the cost of living crisis they're facing in their own personal lives but making compromises in the standards of professionalism they are able to deliver.

Going home at the end of every shift knowing you have not done what you've wanted to is a horrible feeling."

Almost all of the ambulance trusts in England are at such a level of disruption that the environment might not be considered safe and patients might face harm.

The majority have declared so-called critical incidents, with many trusts stating that they were facing huge pressure before strikes began on Wednesday.

Thousands of ambulance workers and paramedics are involved in industrial action in a dispute over pay and conditions.

A critical incident is defined by the NHS as "any localised incident where the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed or the environment is not safe requiring special measures and support from other agencies, to restore normal operating functions".

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