Service crew

West Midlands Ambulance Service: All ambulance services in England ‘at highest level of alert’ due to Covid and heatwave

All ambulance services in England are on the highest level of alert and are under “extreme pressure”, the trusts confirm.

A combination of Covid absences among staff, difficulties caused by hot weather and continued delays in delivering patients to A&E has left ambulance trusts struggling to cope.

Several ambulance services have confirmed to the PA news agency that they are on the highest level of alert after the Health Service Journal (HSJ) reported that was the case for 10 in England. All have been contacted for comment.

The West Midlands Ambulance Service said it was at the highest alert level – known as REAP 4 – for a few months, while the South Central Ambulance Service said that he was also at REAP 4, which means trusts are under “extreme pressure”.

South Central added that it had also declared a critical incident “due to the current pressures on our services”.



Due to recent hot weather and increased demand, we have decided to upgrade to Level 4 of the Resource Escalation Action Plan.

North West Ambulance Service

He said in a statement: “We continue to prioritize our response to patients with serious and life-threatening emergencies but, due to the current pressure levels we are seeing, there will be delays in responding to other patients. with less urgent needs that are assessed as requiring ambulance intervention.

“We are receiving an increasing number of 999 calls in our department, combined with patients calling back if there is a delay in our response. As a result, our ability to respond to calls is seriously challenged.

“This is combined with the challenges of transferring patients to busy hospitals in our region and an increase in Covid infections, as well as other respiratory illnesses, both among staff and in our communities.

“This week we are also facing high temperatures in our region which we know will lead to increased demand on our service. All of these issues combined are impacting our ability to respond to patients.

A North West Ambulance Service spokesperson told PA: ‘Due to recent hot weather and increased demand, we have decided to move to Level 4 of the Resource Escalation Action Plan (REAP ).



Patients are left for far longer than safe and lives are lost as a result

Shadow Health Secretary Wes Streeting

“By moving to REAP Level 4, we will maximize all available resources, increasing staffing levels in emergency call centers and on the road.

‘We urge the public to book the 999 service for emergencies only and find out if their GP, pharmacist or 111.nhs.uk could provide the medical help they need.’

The Southeast Coast Ambulance Service confirmed to the Palestinian Authority that it had upgraded to REAP 4 this week.

A spokesman for the London Ambulance Service said it had moved to REAP 4 ‘due to sustained demand on our 999 and 111 services, and with warm weather expected to continue over the next few days’.

He added: “The public can support us by only calling 999 in life-threatening emergencies and by taking steps to stay hydrated and stay out of the sun during the hottest parts of the day. “

The NHS Trust South West Ambulance Service also confirmed to PA that it was at REAP 4, as did the East Midlands Ambulance Service and the East of England Ambulance Service.

The North East Ambulance Service told the AP it raised its alert level on Monday.

Donna Hay, the service’s strategic commander, said: “Due to continued pressure on our service and broader system pressures, as well as anticipated pressure that will continue over the next week, including increased potential for heat-related incidents, we made a decision to raise our operational alert level to four on July 11.

“The public can continue to support us by only calling 999 in a life-threatening emergency.”



We have a number of staff absences due to an increase in Covid cases as well as additional pressure caused by the current hot weather which makes things even more difficult for our staff and of course the patients whose they take care

Martin Flaherty, Association of Ambulance Chief Executives

Shadow Health Secretary Wes Streeting said: ‘Twelve years of Tory mismanagement has left our ambulance service in crisis.

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

According to HSJ, West Midlands saw more than half of its paramedics queuing outside hospitals at some point on Monday.

A trust spokesman said an ambulance crew had to wait 24 hours to deliver a patient.

Meanwhile, the managing director of an acute trust in the Midlands region told HSJ: ‘We had a very, very difficult night for transfers last night, possibly the worst ever and we are not only in July.”

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

Martin Flaherty, chief executive of the Association of Ambulance Chief Executives, said: “The NHS ambulance sector is under intense pressure, with all ambulance services operating at the highest level of four in their action plans. escalation of local resources, normally reserved for major incidents or short periods of unusual demand.

“Significant delays in the ability of ambulance teams to deliver their patients to many hospital emergency departments is having a very significant impact on the ability of the ambulance industry to respond to patients as quickly as we would like, as our teams and our vehicles are stuck outside of them. hospitals.

“On top of this we have a number of staff absences due to an increase in Covid cases as well as additional pressure caused by the current hot weather which makes things even more difficult for our staff. and of course the patients they care for.

“We are therefore asking the public to help the ambulance service during this difficult time by seeking alternative treatment or advice via NHS 111 online or by calling 111, visiting local urgent care centers or speaking to their local GP or pharmacist.

“During this very hot weather, it’s also important that people stay hydrated, wear sunscreen and stay in the shade whenever possible.

“Ambulance services will continue to prioritize responses to patients with serious and life-threatening emergencies, but, due to current pressure levels, there will unfortunately inevitably continue to be delays in responding to other patients with life-threatening emergencies. less urgent needs that are assessed as requiring ambulance intervention.

“We are also urging people not to call 999 again to request an estimated time of arrival unless the patient’s condition has changed.

“It keeps the line clear for someone who might need urgent help. For people calling 111, we ask that they do not hang up and call back as this will simply send them to the back of the queue.

“The ambulance industry remains committed to working with all parts of the health and social care system to try to eradicate hospital transfer delays and the significant harm they cause to patients, as well as the detrimental impact that they have on the well-being of our staff, our most important asset.