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    How ambulance service strikes will affect patients in Greater Manchester

   North West Ambulance Service says it will ʼuse military support where
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   The strike is scheduled for tomorrow(Image: PA)

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   Thousands of ambulance service staff including paramedics and
   call-handlers in the north west - hundreds in total across Greater
   Manchester - are due to walk out on strike on Wednesday in the biggest
   collective industrial action for 30 years.

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   ʼunprecedented conditionsʼ at A&E departments following images of
   stacked up ambulances outside, combined with the usual pressures of
   winter sickness bugs, Strep A alarm and the nursing strike, the action
   will undoubtedly leave households worried about what to do in the event
   of an emergency - and what urgent care they will receive should the
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     * PM Rishi Sunak urged to reopen talks as NHS admits ʼdeep worryʼ
       patients canʼt be kept safe during strikes

   Unions claimed tonight the health secretary, Steve Barclay, refused to
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   ʼunaffordableʼ after a four per cent rise was rejected, he later
   tweeted: "I hugely value the work of our NHS staff and itʼs
   disappointing some union members are going ahead with further strike
   action - my door remains open to further talks.

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   to make the NHS a better place to work."

   Unisonʼs Christina McAnea said she was ʼvery disappointedʼ strike
   action would definitely go ahead on Wednesday after talks brought ʼno
   movement, saying of the Health Secretary: "He has an envelope and he
   will take back our concerns to the Prime Minister and the Chancellor.
   So no movement and the strike is definitely on tomorrow."
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   Military personnel take part in ambulance driver training in
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   One NHS source in Manchester said they were also concerned about
   ʼinter-hospital transfersʼ and predicted Thursday, the day after the
   strike, would be the ʼworst dayʼ. They told the Manchester Evening News
   : "I am also concerned about time-critical treatments - if youʼve got a
   patient who needs neurosurgery in your emergency department and you are
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   size.

   During the strike, military personnel are not expected to drive
   ambulances on blue lights for the most serious calls, but are expected
   to provide support on other calls. Itʼs thought around 600 members of
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   Talks between unions and ambulance services are ongoing to work out
   which incidents should be exempt from strike action. It is expected
   that all category one calls – the most life-threatening, such as
   cardiac arrest – will be responded to.
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   Paramedic leaders, however, have voiced concerns over patients whose
   conditions deteriorate - moving them up a category of seriousness - and
   said they fear delays could persist after the strike action has
   finished.

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   Mr Barclay said people should call an ambulance if there was a need to
   do so during the strike on Wednesday ʼbut there will be impacts on
   patientsʼ.

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   "So people should continue to call 999 where they need an ambulance.
   But there will be impacts on patients as a result of the strike action.
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   Health Minister Will Quince told anyone with chest pains on Wednesday
   to call 999 despite the strike action by ambulance workers. "If you
   have chest pains, then phone 999. If it is not life-threatening, then
   it’s really important that people call NHS 111 or NHS 111 online,” he