Ambulance staff are set to stage their first of two walkouts on Wednesday, December 21 in a dispute over pay.
Members of the GMB, Unison and Unite unions are among thousands of public sector workers striking in the Christmas period, including the biggest ever UK-wide walkout by nurses.
The strikes will affect the public despite plans in place to mitigate the impact.
Here is what you need to know about ambulance strikes and how it could affect you.
When will ambulance workers go on strike?
Thousands of ambulance workers and other NHS staff will strike on December 21, while paramedics, emergency care assistants, call handlers and other staff will also walk out on December 28.
The ambulance workers' strike will not coincide with the RCN walkouts.
Who is striking?
Paramedics, emergency care assistants, call handlers and other staff will all be walking out as part of the dispute.
How the strikes will unfold
What services will be affected by the strikes?
More than 10,000 GMB ambulance workers voted to strike at nine trusts in England and Wales.
The Unison action will affect five services: London, Yorkshire, the north-west, the north-east and south-west of England.
Unite workers' walkout will affect ambulance services in the West Midlands, north-west and north-east for 24 hours.The GMB members will strike at:
South West Ambulance Service
South East Coast Ambulance Service
North West Ambulance Service
South Central Ambulance Service
North East Ambulance Service
East Midlands Ambulance Service
West Midlands Ambulance Service
Welsh Ambulance Service
Yorkshire Ambulance Service.
What do I do if I need to call an ambulance for a non-life-threatening injury or condition?
People should continue to call 999 where they need an ambulance if, for example, they have had a fall or broken a leg.
The government have said that urgent 999 patients could be taken to A&E during the strikes in taxis. Patients who fall into categories three and four - conditions that are not immediately life-threatening such as an uncomplicated diabetic issue - who may otherwise need an ambulance could be driven in a cab.
GP surgeries are open as usual.
Interim chief executive of NHS Providers Saffron Cordery said if people think they have got the kind of emergency where they would usually call 111, then they should do that, or they should consult a GP or pharmacist.
“They must use the usual routes available to them and take that advice. There may well be alternative advice available to them that wouldn’t ordinarily be the case.
“So perhaps they will be advised to get themselves to hospital, but they should wait to seek that medical advice.”
What if there is an emergency?
Unions have previously said they will respond to life-threatening incidents - known as a category one call - on strike days.
This means that where there is an immediate threat to life paramedics will respond.
Anyone with chest pains on Wednesday to call 999 despite the strike action, Health Minister Will Quince said on Tuesday.
“Call 999, a clinician will assess that call and then consider the appropriate action whether that’s an ambulance, whether it’s community services, whether it’s NHS 111.”
Will anyone be filling in for drivers?
Hundreds of troops have been trained to drive ambulances in an attempt to mitigate the impact on the public, but Downing Street indicated military personnel would not be driving ambulances in response to emergencies.
About 2,000 military personnel, civil servants and other volunteers from across the government have been preparing as ministers brace for a wave of industrial action across the public sector.
Among troops drafted in to cover for striking workers are 600 ambulance drivers, plus a further 150 providing logistical support.
Police officers may be called upon to drive ambulances as paramedics go on strike, the Police Federation has said, although this has not been confirmed.
But the armed forces have just 40 paramedics who would be qualified to work in the NHS, the government has said.
Unions have branded the military deployment a “desperate measure”, warning the servicemen and women are not “sufficiently trained” to plug staffing gaps on the front line, while the Chief of the Defence Staff has said the armed forces should not be treated as “spare capacity”.
Why are ambulance workers striking?
Workers across the ambulance services and some NHS trusts have voted to strike over the government’s 4% pay award, which the GMB union described as another "massive real-terms pay cut".
Rachel Harrison, GMB national secretary, said: "After 12 years of Conservative cuts to the service and their pay packets, NHS staff have had enough.
"The last thing they want to do is take strike action but the government has left them with no choice."
Elsewhere, Sharon Graham, Unite general secretary, said: "Make no mistake, we are now in the fight of our lives for the very NHS itself. These strikes are a stark warning - our members are taking a stand to save our NHS from this government.
"Patients’ lives are already at risk but this government is sitting on the sidelines, dodging its responsibility to sort out the crisis that it has created.
"Ministers can’t keep hiding behind the pay review body. They know full well it does not address the desperate need to get huge numbers of NHS workers off the breadline."
What has the government said?Health and Social Care Secretary Steve Barclay said: “NHS workers do an incredible job caring for our loved ones and it is disappointing some will be taking industrial action, ahead of a challenging winter.
“The economic circumstances mean unions’ demands are not affordable – each additional 1% pay rise for all staff on the Agenda for Change contract would cost around £700 million a year.
“We’ve prioritised the NHS with record funding and accepted the independent pay review body’s recommendations to give over one million NHS workers a pay rise of at least £1,400 this year, with those on the lowest salaries receiving an increase of up to 9.3%.
“This is on top of the 3% award last year when wider public sector pay was frozen and on top of the wider government support to help with the cost of living.
“Our priority is to ensure emergency services continue to operate for those who need it and limit disruption, particularly at a time when NHS services are under huge pressure due to the impact of Covid.
“People should continue to use NHS 111 online for urgent healthcare advice and call 999 if it is a life-threatening emergency.”
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