Heatwave: Ambulance services are put on the highest level of alert and are under 'extreme pressure'

ITV News Correspondent Neil Connery reports on the dangers the heatwave is posing

England's ambulance services are on the highest level of alert and are under “extreme pressure” as the heatwave intensifies problems with Covid-hit medical staff and ongoing delays accessing A&E departments.

All 10 of the country's trusts have declared "critical incidents", the Association of Ambulance Chief Executives (AACE) told ITV News. 

Martin Flaherty, AACE Managing Director, said that England’s ambulance services are operating at a level usually reserved for major incidents.

“Severe delays in ambulance crews being able to hand over their patients at many hospital emergency departments are having a very significant impact on the ambulance sector’s ability to respond to patients as quickly as we would like to, because our crews and vehicles are stuck outside those hospitals," he said.

“Added to this, we have a number of staff absences due to a rise in Covid cases as well as additional pressure caused by the current hot weather, which is making things even tougher for our staff and of course the patients they are caring for."

The highest level of alert for ambulance trusts is known as Resource Escalation Action Plan (REAP) Level 4, which indicates a "potential for failures" within the service.

REAP 4 means trusts are under “extreme pressure”. Credit: NHS

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West Midlands Ambulance Service said it has been at REAP Level 4 for a few months.

South Central said that its capacity to manage 999 calls was being stretched as patients were also calling back to query the delays in responding to them.

“This is combined with the challenges of handing patients over to busy hospitals across our region and a rise in Covid infections, as well as other respiratory illnesses, among both staff and in our communities," a South Central statement added.

“This week we are also faced with high temperatures across our region which we know will lead to an increase in demand on our service. All of these issues combined are impacting on our ability to respond to patients.”

A North West Ambulance Service spokesman said it had reached the highest level “as a result of the recent warm weather and increased demand."

“In moving to REAP Level 4, we will be maximising all available resources, increasing staffing levels in emergency call centres and on the road," the spokesman added.

A London Ambulance Service (LAS) spokesman said it had moved to REAP 4 “as a result of a sustained demand on both our 999 and 111 services, and with hot weather set to continue over the next few days”.

South East Coast Ambulance Service, South Western Ambulance Service NHS Trust and the East Midlands Ambulance Service also confirmed they have moved to REAP 4 this week.

South Western Ambulance Service NHS Foundation Trust. Credit: PA

Shadow health secretary, Wes Streeting, said: “Twelve years of Conservative mismanagement has left our ambulance service in crisis.

“Patients are left for far longer than is safe and lives are being lost as a result.”

An NHS spokesperson said: “Near record levels of 999 calls, challenges discharging patients to social care settings, increasing Covid cases - leading to more than 20,000 staff absences – and the current heatwave is inevitably having an impact on NHS capacity.

"It however remains vital that the public continue to dial 999 in an emergency and use 111 online, or their local pharmacy for other health issues and advice.”

West Midlands had more than half of its ambulance crews queued outside hospitals at one stage on Monday, according to HSJ.

A spokesman for the trust said one ambulance crew had to wait 24 hours to hand a patient over.

Meanwhile, the chief executive of an acute trust in the Midlands region told the Health Service Journal (HSJ): “We had a very very challenged night for handovers last night, possibly the worst ever and it is only July.”

South East Coast Ambulance Service told HSJ it escalated to REAP 4 on Monday, saying the incident was called following “sustained pressure on both our service and wider system”, with hot weather a major factor.

AACE advised the public to seek advice via NHS 111 or by calling 111, visiting local urgent care centres or speaking to their GP or local pharmacist.

It also advised people to stay hydrated, wear suncream and stay in the shade where possible.

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