Ambulance trusts are struggling to cope as a combination of hot weather, Covid absences among staff and delays in handing over patients to A&E piles on the pressure.
Several ambulance services confirmed they were on the highest level of alert after the Health Service Journal (HSJ) reported this was the case for all 10 in England.
West Midlands Ambulance Service said it had been on the highest level of alert – known as REAP 4 – for a few months, while South Central Ambulance Service said it 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 current pressures on our services”.
Ambulance trusts are struggling to cope
Dominic Lipinski
Labour's Wes Streeting hit out at '12 years of mismanagement'
UK Parliament/Jessica Taylor
It said in a statement: “We continue to prioritise our response to those patients with life-threatening and serious emergencies but, due to the current levels of pressure we are seeing, there will be delays in responding to other patients with less urgent needs who are assessed as requiring an ambulance response.
“We are experiencing an increasing number of 999 calls into our service, combined with patients calling back if there is a delay in our response to them. As a result, our capacity to take calls is being severely challenged.
“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.
“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: “As a result of the recent warm weather and increased demand, we have decided to step up to Level 4 of Resource Escalation Action Plan (REAP).
“In moving to REAP Level 4, we will be maximising all available resources, increasing staffing levels in emergency call centres and on the road.
“We urge the public to reserve the 999 service for emergencies only and consider if their GP, pharmacist or 111.nhs.uk could provide them with the medical help they need.”
South East Coast Ambulance Service moved to REAP 4 this week.
A London Ambulance Service 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”.
He added: “The public can support us by only calling 999 in the event of a life-threatening emergency and by taking steps to keep hydrated and stay out of the sun at the hottest periods of the day.”
South Western Ambulance Service NHS Trust is also at REAP 4, as is the East Midlands Ambulance Service.
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.”
According to HSJ, West Midlands had more than half of its ambulance crews queued outside hospitals at one point on Monday.
A spokesman for the trust said one ambulance crew had to wait 24 hours to hand a patient over.
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.