Thousands of nurses staged a second walkout on Tuesday, as the government urged people to avoid “risky” activities during a planned ambulance strike the following day.
UK ministers say the salary rise demanded by nurses is unaffordable, triggering a bitter dispute with the Royal College of Nursing (RCN).
It comes as health minister Will Quince urged people to stay safe on Wednesday, which will probably see the NHS hit by major disruption as ambulance workers including paramedics, control room workers and technicians walk out in England and Wales.
During the strike, the military will not drive ambulances on blue lights for the most serious calls but are expected to provide support on other calls.
A senior officer has said there will be “nerves” among military personnel who are missing Christmas leave to drive ambulances.
About 600 members of the Army, Navy and RAF from across the country have been drafted in to help during the walkouts, some of whom have never driven the vehicles before.
Lieutenant Colonel James Shaw, Brigade Major of the Household Division, said the experience would be new to some personnel but troops were “confident” and had “a huge amount of initiative”.
The officer, who is overseeing training for the task at Wellington Barracks in London, said: “I think there’ll be a few nerves going out tomorrow – it’s a really important task and I think we’re incredibly proud.
“And obviously being military, you just want to do the best you can possibly do on this sort of thing, so I’m sure there will be a few nerves.”
Members of the armed forces taking part in the two days of training at the barracks said they were “nervous” but “honoured” to cover for ambulance workers, despite having to sacrifice time off.
Paramedics and nurses are among several professions striking across the UK this month over pay as consumer price inflation remains around 10 per cent.
The nursing union has been calling for a pay rise of 5 per cent above inflation, although it has indicated it would accept a lower offer.
The government has implemented the recommendations of the independent pay review body, which gave nurses a rise of about 4.75 per cent, with a guaranteed minimum of £1,400 ($1,700).
Nurses strike in the UK — in pictures
RCN chief executive Pat Cullen called on the government to meet the union for talks.
“We will negotiate with government,” she told Radio 4's Today show on Tuesday. “We won’t dig in if they don’t dig in. But we have no opportunity to do that because we can’t get to a table to talk to government.”
“We want this resolved before Christmas and it is incumbent on the Prime Minister now to make sure that happens,” she added.
The National Health Service was running a bank holiday-style service in many areas on Tuesday as thousands of operations and procedures have been cancelled or rescheduled.
The RCN has said it is staffing chemotherapy, emergency cancer services, dialysis, critical care units, neonatal and paediatric intensive care, and some other services.
Health Secretary Steve Barclay said: “The RCN’s demands are unaffordable during these challenging times and would take money away from front-line services while they are still recovering from the impact of the pandemic.
“I’m open to engaging with the unions on how to make the NHS a better place to work.”
UK strikes — in pictures
Health minister Will Quince said armed forces personnel would play a key role during Wednesday's ambulance strike. But they would not be able to “break the law” when covering for ambulance workers.
Mr Quince urged the public to avoid anything risky on the day, telling BBC Breakfast: “Where people are planning any risky activity, I would strongly encourage them not to do so because there will be disruption on the day.”
The health minister did not offer examples of what might be defined as risky behaviour but told the public that in any emergency calling 999 should still be the first option.
“But the key thing is for anybody that does have an emergency situation or a life-threatening situation that they continue to call 999 as they would have done previously, and for any other situation, NHS 111 or NHS 111 online.”
Later on BBC Radio 4, he also said that anyone with chest pains on Wednesday should still call 999.
Downing Street later declined to set out what “risky” activities might include, with the Prime Minister's official spokesman telling reporters: “The public, as we saw through Covid, can be trusted to use their common sense.”
Negotiations between unions and ambulance services are ongoing to work out which incidents should be exempt from strike action.
It is expected that all category 1 calls, the most life-threatening, such as cardiac arrest, will be responded to.
Some ambulance trusts have agreed exemptions with unions for specific incidents within category 2, which covers serious conditions, such as stroke or chest pain.
This means those who suffer certain accidents, falls or other non-life-threatening injuries may not receive treatment.
British nurses stage first strike in bitter pay dispute with government — video
At least three ambulance services have declared “critical incident” status as NHS services around the country face “unprecedented” pressure ahead of planned strike action.
North-East Ambulance Service, South-East Coast Ambulance Service and the East of England Ambulance Service have all moved to the status as staff work to respond to calls.
The services said they took the decision due to pressures including 999 call volumes and hospital handover delays, and that declaring the status allows them to instigate additional measures to protect patient safety.
North-East Ambulance Service operates across Northumberland, Tyne and Wear, County Durham, Darlington and Teesside; South-East Coast Ambulance Service covers Brighton & Hove, East Sussex, West Sussex, Kent, Surrey and North-East Hampshire; while the East of England Ambulance Service works in Bedfordshire, Hertfordshire, Essex, Norfolk, Suffolk and Cambridgeshire.
North-East Ambulance Service said it declared a critical incident on Monday afternoon as a result of “significant delays for more than 200 patients waiting for an ambulance, together with a reduction in ambulance crew availability to respond because of delays in handing over patients at the region's hospitals”.
Stephen Segasby, chief operating officer at the service, said: “Our service is under unprecedented pressure.
“Declaring a critical incident means we can focus our resources on those patients most in need and communicates the pressures we are under to our health system partners who can provide support.
“We are asking the public to call us only in a life-threatening emergency.”
Mr Segasby urged other patients to speak to their GP or pharmacist, or to use the NHS 111 website.
“Our staff and volunteers continue to work extremely hard to respond to calls and incidents,” he said.
“I would like to take this opportunity to thank them for their hard work and commitment at this challenging time.”
UK rail strikes cause disruption for millions amid cold snap — in pictures
On Tuesday, a fresh strike was announced by drivers at 15 train companies who are members of the Aslef trade union.
The action will take place on January 5, between strikes already announced by the RMT on January 3-4 and 6-7 as part of an ongoing dispute over pay.
Mr Sunak said on Monday that the government had adopted a “fair and responsible approach to pay”.
“I’m really disappointed to see that the unions are calling these strikes, particularly at Christmas, particularly when it has such an impact on people’s day-to-day lives with the disruption it causes and the impact on their health.
“I would urge them to keep considering whether these strikes are really necessary and do everything they can to alleviate the impact it’s going to have on people.”