When Paul Turner goes to work as a paramedic, he increasingly finds himself waiting for hours outside a hospital. Sometimes he will sit there for an entire 12-hour shift, with a patient in the back going without hospital treatment.
“It’s the worst it’s ever been,” the veteran of the North West Ambulance Service tells me. “I’ve been talking about how underfunded the NHS is for probably a decade… People are already waiting hours upon hours for ambulances, we can’t provide the service that we want to give to the public.”
Ambulance staff across England and Wales will go on strike on the 21st December, as part of a walkout coordinated by Unison, Unite and GMB. Many see striking as the final option for fixing an emergency healthcare system that has been silently breaking for years.
Paramedics and ambulance technicians, he says, now have workloads so high that they spend their entire 12-hour shifts responding to calls, often without any break. “It’s very unusual for you to finish on time,” Turner, who is also a GMB rep, says.
In August alone, 42,000 patients nationwide waited longer than an hour for handover at a hospital, which is almost 15,000 more than last year. As many as 552 patients waited over ten hours. One UK trust actually recorded a 24-hour hospital handover—a record wait.
And it’s not just the paramedics on the frontline who face enormous pressures. Call handlers for the 111 non-emergency services also report an overwhelming volume of calls. Even before the pandemic, John*—who is a call handler for the London Ambulance Service—was worried that the number of calls was increasing, which he mentioned to senior members of staff: “I remember even telling one of the directors that the place had become like a sweatshop, but that concern was ignored.” One weekend, he says there were between 500 and 650 patients waiting in the queue for a call back.
John has worked for the service for seven years and says that some call handlers are being forced to work as many as seven days a week after overtime in order to pay their bills. Concerns around pay are common across the service. Wages for qualified paramedics range from £25,655 to £39,027 a year (Band 5 or 6 on the NHS pay scale), but are lower for other staff like emergency medical technicians who also attend incidents. Paul says he knows of many ambulance staff who work upwards of 100 hours of overtime a month to pay their bills and plug the staffing gaps in the service.
Like other NHS workers, ambulance staff have been offered at least a 4 per cent pay rise by the government. But TUC research found that the average paramedic is £5,600 poorer per year in real terms than in 2010, one of the largest drops in real pay in the entire health service.
The collective impact of these conditions has led many workers to leave the service. Paul estimates that one station he works with in the northwest lost almost 15 per cent of its 70-person workforce in just three months.
The situation has continued to escalate, with workers now forced to take industrial action. A North West Ambulance Service spokesperson—speaking before the strike action was confirmed—said that the situation was “the result of a national pay dispute and not one we can control. We recognise this is a difficult time across the country, including for our staff who work incredibly hard to support the people of the North West.” They stressed their plan “to minimise any impact on patients” in the event of walkouts. A spokesperson for the London Ambulance Service said that it would "work closely with our unions, staff and other partners to try and minimise any potential impact on our patients.”
Many of the workers I spoke to emphasised the long shadow that has been left by cuts. In a huge interdependent network like the health system, reliant on countless different teams from paramedics and call handlers to A&E doctors, GPs and social care workers, when one is underfunded and understaffed it can bring the others down with it. A 31 per cent cut in spending for over-65s social care between 2010 and 2018, for example, led in turn to a significant increase in the number of patients over 65 visiting A&E, according to one study by the Institute for Fiscal Studies. Often the reason ambulance services face huge delays is because shortages of A&E beds leave ambulances serving as an alternative to patients being left untreated in hospital corridors.
Concerns about pay and fears about the lack of funding for the service underpin the industrial action now announced by the ambulance unions. They claim it will be the biggest ambulance strike in 30 years.
“It’s never been this way. We’ve been busy all of my career, but not to the extent that we are now. I see people leaving their shifts in tears because of the pressure that they’re under,” Turner says. “I’m really concerned about what the ambulance service is going to look like in years to come.”
*Some names have been changed
This article has been updated to include a response from the London Ambulance Service
