The army could answer 999 calls if ambulance personnel in England go on strike over their pay, under NHS plans to keep services running during strikes.
Military personnel will be brought in if, as looks likely, ambulance staff such as paramedics and emergency medical technicians withdraw their labour in the next few weeks.
St John Ambulance and the British Red Cross, which have their own ambulances, will also be asked to help, under plans drawn up by NHS England and the Department of Health and Social Care.
Ministers may also ask firefighters to help out. However, their deployment is more complicated because the Fire Brigades Union is conducting a consultative ballot of its members about a 5% pay offer they have been made, which could lead to them taking strike action.
“Use of the army is on the list of potential contingencies [to help the NHS],” a senior health service official said. “It’s in the ‘not unrealistic’ scenario.”
Steve Barclay, the health secretary, met Pat Cullen, the general secretary of the Royal College of Nursing (RCN), after the RCN’s strike ballot, which will mean strikes by nurses in most NHS places of care across the UK next month. However, there was no movement on either side, and no discussion of a compromise to avoid walkouts, so the nurses’ action looks set to go ahead.
NHS bosses are acutely concerned about how strikes by ambulance workers could leave the health service unable to get patients needing urgent medical care to hospital quickly. That is their greatest worry about how the impending wave of strikes across the NHS could affect patients, ahead of the disruption that strikes by nurses will bring, the Guardian understands.
That is because all ambulance services across the UK are already under such huge pressure that response times to 999 calls are by far the worst on record, even when they are fully staffed. Hours-long delays in ambulance crews handing patients over to A&E and getting back on the road to respond to other emergencies are leaving 4,100 sick people a month in England exposed to potentially “severe harm”, ambulance service bosses estimate.
A well-placed NHS source said: “The biggest challenge will be if ambulance service staff vote to strike. Strikes by ambulance staff are such a worry mainly because of how much pressure they are under and how services could reasonably be expected to maintain a high level service with so many paramedics off. It’s not like other services where you can, to an extent, ration services, for example by not doing elective surgery [in order] to put more staff into emergency care.”
On Thursday, the GMB union said strikes by its members who work in ambulance services were expected to start before Christmas, the same timeframe as the first strikes by RCN members.
Ambulance service staff in Scotland and Northern Ireland who belong to the GMB have already voted to strike in protest at the government’s offer of a £1,400-a-year pay rise for most NHS staff. A ballot of their counterparts in England and Wales is under way.
“Preparations are now being made for industrial action before Christmas,” Rachel Harrison, the GMB’s national secretary, said on Thursday. “What strike action looks like will be determined locally and could include a ban on overtime – which the ambulance service relies heavily upon – or working strictly to rule and terms of contracts.
“No NHS worker votes for industrial action lightly, but these workers are desperate. This [dispute] is as much about patient safety as it is about pay.”
Nurses in many of England’s 10 regional ambulance trusts have voted to strike, as have nurses working for the ambulance services in Scotland, Wales and Northern Ireland.