Hospitals should free up beds by safely discharging patients in advance of “extensive disruption” caused by industrial action by ambulance crews, health chiefs have said.

They warned of “a very challenging period” when ambulance crews in England and Wales are due to walk out for two days on 21 and 28 December in a dispute over pay.

It follows Thursday’s one-day strike by nurses in England, Wales and Northern Ireland.

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In a joint letter with national medical director Professor Sir Stephen Powis and chief nursing officer Dame Ruth May to NHS trusts and integrated care boards, Sir David Sloman, NHS England’s chief operating officer, said measures should also be put in place to ensure ambulance patient handovers are kept to no more than 15 minutes.

NHS data shows ambulance handover delays at hospitals in England have hit a new high, with one in six patients last week waiting more than a hour to be passed to A&E teams.

Just over one in three had to wait at least 30 minutes. The numbers are higher than at any point in recent winters.

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NHS Providers’ interim chief executive Saffron Cordery said “Trust and system leaders are being asked by NHS England to focus on reducing handover delays and maximising capacity in urgent and emergency care.

“But given the scale of operational pressures on providers now including very high bed occupancy levels, rising flu admissions, ongoing COVID-19 pressures, record staff absences and increasing A&E attendances, this will be incredibly difficult to implement.

“We understand why ambulance staff have voted for industrial action but it’s vital that the government and unions talk urgently to find a way to prevent this and further strikes from happening.”

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The first nurses’ strike in a century

Meanwhile, Pat Cullen, the general secretary of the Royal College of Nursing (RCN), has said Health Secretary Steve Barclay’s “macho” negotiating style is hampering efforts to resolve the nurses’ pay dispute.

She said that when she met Mr Barclay in the House of Commons on Monday, it had been “very confrontational” with him refusing to discuss pay.

“I see a macho culture in this government,” she said.

“He needs to get to a place where he’s inspired with the value of care and treatment. He doesn’t value that because it’s a 90% female profession.”

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‘We hugely value nurses,’ says Steve Barclay

Following Thursday’s strike, RCN members are due to walk out again on Tuesday.

Ms Cullen urged Prime Minister Rishi Sunak to step in before the dispute “engulfs” the NHS, warning there would be a further “escalation” of the nurses’ action in January involving longer stoppages and more organisations.

On a visit to Belfast on Friday, Mr Sunak insisted that while “the door is always open to talks” the government was determined to stick to the recommendations of the independent pay review body.

“We want to be fair, reasonable and constructive, that’s why we accepted the recommendations of an independent pay body about what fair pay would be,” he said.

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The NHS pay review body has recommended below-inflation pay rises of around 4% for nurses and the government is refusing to negotiate with unions who want a higher offer because it has accepted this recommendation.

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The nurses’ strikes explained

It has emerged that nearly 16,000 appointments, procedures and surgeries were rescheduled in England – 54,000 less than the government suggested – due to Thursday’s strike.

The figures were published after Health minister Maria Caulfield said around 70,000 appointments would be lost due to the industrial action.

But, according to provisional NHS data reported by trusts where the RCN strike took place, 2,452 inpatient and day case elective procedures and 13,327 outpatient appointments were rescheduled, coming to 15,779 in total.

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Across England, 9,999 staff were absent from work due to the strike, according to figures on the NHS England website.

The highest numbers were seen in the South West where striking staff came to 2,372, with 2,023 in the Midlands and the next highest, 1,714 in the North East and Yorkshire.