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Ambulance Services: Minimum Service Levels

Volume 740: debated on Wednesday 8 November 2023

The Government are focused on making the hard but necessary long-term decisions that are in the best interests of the country, to put the UK on the right path for the future. The Government’s priority is to ensure that when strike action takes place in the NHS, the safety of patients is protected as far as possible.

Minimum service levels are in place in a range of countries in Europe and beyond, as a way of balancing the ability of employees to strike with the needs of the public. The International Labour Organisation (an agency of the United Nations) recognises that this is justifiable for services where their interruption would endanger citizens’ life, personal safety or health. Disruption to ambulance services puts lives at immediate risk.

On 6 November 2023, the Government published the response to the consultation on “Minimum service levels in event of strike action: ambulance services in England, Scotland and Wales”. In it we confirmed that, subject to parliamentary approval, we will introduce regulations which set minimum service levels and cover the 10 NHS ambulance trusts in England, as well as the ambulance services provided by the Isle of Wight NHS Trust. While the UK Government think that people across the UK should be able to be confident about what types of situations the ambulance service will respond to on strike day, they recognise that responsibility for the operation of these services in Scotland and Wales lies with the devolved Administrations. We therefore intend for the regulations to apply to England only at this time, rather than also including Scotland and Wales.

The services included in the minimum service levels will be the 999 and healthcare professional (HCP) call handling and emergency ambulance response to those calls, inter-facility transfers (IFT) and non-emergency patient transport services (NEPTS). The overarching principle is that those cases that are life-threatening, and those for which there is no reasonable clinical alternative to an ambulance response, should receive a response as they would on a non-strike day. In the case of NEPTS, patients for whom there is no reasonable clinical alternative to the patient receiving health services on the strike day should have their transportation provided as they would on a non-strike day.

Our response to the consultation reaffirms our commitment to ensuring that patients can access ambulance services when they need them during a strike. We have laid regulations which will address the inconsistency and uncertainty of relying on the unions to agree arrangements on a case-by-case basis, by giving employers the power to issue work notices should they need to. This will increase public confidence in the service and better protect patient safety during periods of industrial action.

The Government will shortly lay a statutory code of practice in Parliament for approval on the reasonable steps trade unions should take in order to meet the legal requirements under the Act. This follows a commitment made during the passage of the Act through Parliament to bring forward such a code of practice and the recent conclusion of a public consultation on the draft code. Separate non-statutory guidance will also be published shortly on the issuing of work notices by employers, where the regulations apply, to secure minimum levels of service on strike days. The consultation response has been published on The Government wish to thank everybody who took the time to provide feedback as part of the consultation process.