Dr Keith Girling, the medical director at Nottingham University Hospitals NHS Trust, apologised to patients as operations were cancelled and relatives were urged to collect those people who could be taken home.
In Wales, the Betsi Cadwaladr health board declared an incident, warning of “extremely long waits” amid “unprecedented” demand, with “all but the most urgent procedures” suspended and warnings that the strikes would limit the ability to respond even further.
North West Ambulance Service had more than 750 patients awaiting an ambulance as of Monday afternoon, with more than 70 calls waiting to be answered, said a source.The trust declared a critical incident as services struggled to cope with demand over the weekend, which has since been stood down.
An agreement between South East Coast Ambulance Service and the GMB union says that even if a major incident is declared because of pressures on services, it would not mean any staff would come off the picket line.
North West Ambulance Service NHS Trust has yet to reach agreement with unions about which patients will receive a response during the strikes. However, union sources have said strikers would not leave picket lines if such an incident was declared.
Senior NHS leaders have warned that Wednesday’s ambulance strikes are “on a completely different order of magnitude of risk” to industrial action by nurses.
The first strike last Thursday by the Royal College of Nursing resulted in about 16,000 cancelled operations, with similar consequences expected with a second strike on Tuesday.
But the precarious state of NHS accident and emergency care has left senior figures concerned that the actions of strikers could result in a crisis from which the health service cannot recover.
Matthew Taylor, the chief executive of the NHS Confederation, said: “It’s clear this is becoming critical, and we’ve rarely heard such strong and urgent expressions of concern from NHS leaders.
“There is now deep worry about the level of harm and risk that could occur this week with the ambulance strikes, and we know this is only going to get worse with future strikes planned. The Government and unions must bring an end to this, otherwise patients will suffer.”
On Monday, Mr Barclay was confronted over strikes by the mother of a child with cystic fibrosis, who said it was unfair to blame the NHS.