London Ambulance Service bolsters emergency care in preparation for winter

“Look after yourselves, family, friends and neighbours”, says capital’s chief paramedic

The London Ambulance Service (LAS) is bolstering its emergency care operations ahead of winter.

It has developed a 999 Winter Plan for 2024 that will mean more ambulances on the streets, more emergency care clinicians available to patients over the phone, and strengthened emergency care coordination across the NHS in the capital.

Developed with NHS system partners, including integrated care boards and the capital’s hospitals, the plan includes:

• Increasing the number of ambulances on the streets and staff in control rooms by more than 10 per cent throughout the week and putting up to 60 additional ambulances on the road at peak times to meet demand.
• Increasing the number of clinicians who are able to ‘hear and treat’ patients over the phone – giving expert medical assessments and advice to reduce the number of people going to A&E unnecessarily wherever possible.
• Maximising use of other forms of care with smoother access into local non-A&E services and more use of specialist mental health cars and community response cars, which pair paramedics with nurses to reach vulnerable people.
• Strengthening day-to-day pan-London coordination with a special control centre at LAS to monitor emerging issues and work with NHS partners to resolve them.
• Strengthening pan-London protocols for times of pressure to ensure all parts of the system understand their role and prioritise essential actions so care is available for the sickest patients.

Pauline Cranmer, London Ambulance Service’s Chief Paramedic, said:

“Winter is always a tough and busy time for the NHS – and for many people in our city – so we will do everything we can to ensure our patients get the right care and to prepare for every eventuality.

“We are going into this winter with the clearest plan we have ever had, created in partnership across the NHS. I am optimistic we will see a well-coordinated and joined up effort from the NHS right across the capital.

“We will be doing our part by increasing the number of staff in our 999 and 111 control rooms, putting dozens more ambulances on the road each day and increasing the number of clinicians who can diagnose and potentially treat patients over the phone so they don’t have to go to hospital unnecessarily.”

NHS London Medical Director Dr Chris Streather said:

“NHS organisations across London are working together to tackle the high demand for services, whether that is people needing emergency care, seeking vital care from their GP or attending an urgent treatment centre.

“We are monitoring the pressure on health and care services across the capital in real time, so we are able to respond to winter pressures and provide timely care to everyone who needs it. People are encouraged to use NHS 111, pharmacies or their GP in the first instance for urgent care that is not a serious medical emergency.”

As the nights have drawn in over recent weeks, 999 calls volumes have risen by almost 10 per cent and now hover around 6,000 a day, similar to pressure seen in winter 2020. In October alone, the LAS received 650 more 999 calls a day than the same month in 2023. But that pressure is set to increase further, with Monday 25 November seeing more than 7,000 calls into London Ambulance’s 999 services – a number of emergency calls usually only seen on New Year’s Eve,

As a result of this increase in demand, the Trust this week moved to its highest level of escalation (REAP 4).

The recent spike in call numbers comes due to the combined impact of wintery temperatures and rising rates of viral infections and respiratory illnesses and they are expected to rise further in the weeks ahead.

As the ambulance service finalises its preparations, it is once again asking Londoners for their help so it can continue to reach the most seriously injured and sick patients quickly.

Pauline Cranmer said: “Clearly it’s already starting to get very busy for time of the year. While we have made preparations, I would like to encourage the public to do the same. I would like to say to Londoners: look after yourselves, your families, friends and neighbours this winter.

“We know infections are on the rise nationally, so we encourage those who are eligible to have their flu and COVID-19 vaccinations. We can see from the patients we go to every day that many people are struggling financially, with loneliness and with long-term conditions.

“Little actions can make a big difference so we would urge Londoners to stay warm, take your medications, and seek medical help if you need it, without ignoring your symptoms. NHS 111 online is always a good place to start

“We hope people enjoy their pre-Christmas celebrations but they do always mean we see more alcohol-related incidents that could be avoided. We ask the public to drink responsibly, plan their journeys back at night so they get home safely, and of course look after their friends.”

London Ambulance stresses that it is important that Londoners use the 999 service wisely: only calling when it’s a serious medical emergency so clinicians can prioritise responding to the most seriously ill and injured patients.

If it’s urgent, but it’s not a serious medical emergency, please consider other options such as your GP, pharmacies or NHS 111 online. NHS 111 online should be your first port of call if you’re unsure what to do or unsure whether to go to A&E. Accessing 111 on line is quick and simple, but if you cannot access it, call 111 by phone.

Londoners can also go to an urgent treatment centre if they need urgent medical attention, but it’s not a life-threatening situation. Conditions that can be treated at an urgent treatment centre (also known as a walk-in centre or minor injury unit) include sprains, suspected broken limbs, cuts and grazes and minor scalds and burns.