Publish date: 9 January 2023

Industrial action is planned to take place at East Midlands Ambulance Service (EMAS) on Wednesday 11 January 2023, from 00.01 hours to 23.59 hours.

The GMB trade union received enough votes to have a mandate to strike and take action short of a strike in response to the national pay dispute with the government. NHS pay levels are agreed at a national, not local, level and are therefore negotiated nationally for NHS employees.

Many staff at EMAS are members of a trade union. We have a workforce of over 4,000 people which includes colleagues across all areas of our organisation eg A&E frontline ambulance crews, 999 control rooms, Non-Emergency Patient Transport Services and Enabling Services. GMB trade union members taking this action may affect up to 50% of staff.

Whilst we fully recognise and respect an individuals’ legal right to participate in industrial action, our underlying duties and responsibilities are to ensure that patient or staff safety, welfare, dignity, or respect are not jeopardised by industrial action. 

Ben Holdaway, Director of Operations at EMAS, said:

“Industrial action last took place at EMAS on 21 December 2022, and despite a 33% reduction in emergency and urgent calls on the day, it remained immensely challenging.

“We are again working closely with trade union colleagues, and NHS and blue-light service providers across the region to do all we can to minimise the impact on patient safety.

“Our operational teams have developed contingency plans to aim to maximise the number of ambulance staff and volunteers we have available to respond to patients, as well as clinical staff able to carry out remote clinical assessments. 

“However, we again anticipate that on Wednesday there will be fewer ambulances available and therefore our responses to our patients will, inevitably, be much slower on the day. 

“Where possible, our 999 control rooms will carefully assess and prioritise an ambulance response for those who need it most, and this may only be where there is a threat to life. 

“Despite huge pressures, the NHS remains open and people are asked not to store up their health conditions or soldier on over the coming days if they are unwell – seek early advice from your local pharmacist, NHS111 online, via your local GP or Urgent Treatment Centre; and if you have a long-term condition, ensure you continue to take your routine medication as advised by your GP.

“It is important that the public use services wisely and make their own way to a treatment centre or hospital if safe to do so; this allows us to send our ambulances with life-saving equipment and clinicians on board to people who really need them.”

We fully respect the right of NHS staff to take lawful and peaceful industrial action, however we do urge national employer representatives and trade union colleagues to proactively engage and reach a negotiated settlement to the dispute as quickly as possible.


Constructive conversations between trade unions and EMAS senior leaders have now concluded and mutually acceptable derogations (also known as exemptions) have been agreed. 

On the day of the strike, many GMB members due to be at work at EMAS will need to personally make a decision whether to attend work as normal or whether to take part in the industrial action – either by exercising their right to strike or through deciding to work under exemptions agreed with their trade union. 

For our A&E ambulance service, these exemptions include either only responding to Category 1 calls (immediately life-threatening) or attending Category 1 calls and the most serious Category 2 calls such as chest pain, FAST-positive strokes, gynaecology emergencies where mother or baby are at risk, road traffic collisions where a patient is trapped, and unwell children aged five and under. 

For staff working in our Non-Emergency Patient Transport Service in Derbyshire and Northamptonshire, these exemptions include only attending patients travelling for renal treatment or oncology treatment, or palliative care patients who are returning home or travelling to a hospice. 

For staff working in our Clinical Assessment Team (CAT) in our control room, these exemptions mean they will only provide support to patients on the CAT stack and will not perform any other duties.

Frequently Asked Questions


Q: What should people do if they need an ambulance?

A: Patients should only call 999 if there is a risk to life, or if seriously ill or injured. Ambulances will be dispatched where clinically appropriate. 

For all other health care needs, support will be available through NHS111 online or at a local GP surgery or pharmacy. 

Q: What is considered an emergency, and will my 999 call be answered?

A: Patients should only call 999 if there is a risk to life eg cardiac arrest, unconscious or catastrophic bleed, or if seriously ill or injured eg stroke or a serious traumatic injury. Ambulances will be dispatched where clinically appropriate. 

Q: How many fewer ambulances will you have responding to emergencies in the East Midlands?

A: It is not possible to say how many colleagues will be participating in industrial action as it is a personal decision made on the day of action by individual members of the trade union which has the mandate to strike.

We have been working with our local and national trade union representatives to agree exemptions for patients which some GMB members may still attend during the period of industrial action. 

Our operational teams have been carefully planning with an aim to maximise the number of ambulance staff and volunteers we have available to respond to patients on the days of industrial action to seek to ensure that we continue to be able to respond to life-threatening or emergency situations.

Q: If the ambulance is taking a long time to arrive, what should I do?

A: It is likely to take us longer than normal to get to patients on the day of industrial action because there will be fewer ambulances available. 

Our 999 control rooms will carefully assess and prioritise an ambulance response for those who need it most, and this may only be where there is a threat to life. 

You may be asked to make your own way to hospital or a medical treatment centre if it is safe to do so.

If you are waiting for an ambulance, please do not call 999 again to ask for an updated estimated time of arrival for an ambulance. 

You should only call 999 again if you wish to cancel the ambulance because you are making their own way to hospital, or if the patient’s condition has significantly worsened. 

Q: Will my non-emergency patient transport be impacted?

A: Some of our Non-Emergency Patient Transport Services (PTS) staff are members of the GMB union and therefore may take part in industrial action on the planned strike day. Please note EMAS only provides PTS in Northamptonshire and Derbyshire.

Our PTS planning teams have been preparing to minimise the disruption to our patients during this period of industrial action. 

Patients should expect their booked routine transport to arrive as normal and should attend their appointments as normal, unless contacted directly by the hospital or the ambulance service to inform you of a cancellation.  

Throughout this period of industrial action, transport to chemotherapy and kidney dialysis appointments, as well as hospital discharges, will be prioritised to ensure patients continue to receive the life-saving treatments they need. 

Any patients with additional questions can contact our NEPTS booking telephone line on 0300 300 34 34.

Q: Do I need to cancel my transport and hospital appointment for the days of industrial action?

A: No. Patients should expect their booked transport to arrive as normal and should attend their appointments as normal, unless contacted directly by the hospital or the ambulance service to inform you of a cancellation.  

Q: If staff are already on shift and treating a patient when the industrial action begins, will they just stop working?

A: If delivering patient services, staff must complete the patient call they are on before they are permitted to stand down; this includes in call centres as well as direct patient care. 

Q: Will you be receiving support from the military?

A: There are no plans for military support at this time. 

Q: Where will the picket lines be held?

A: Picketing is likely to take place at the ambulance stations across the East Midlands where union members who are participating in industrial action are based. 

Q: Can members of the public join the picket lines?

A: No - not as part of official picketing. 

However, they could be present and exercising their human right of protest despite not being part of the official picket. 

The Code of Practice on Picketing states ‘anyone seeking to demonstrate support for those in dispute should keep well away from any picket line so as not to create a risk of a breach of the peace or other criminal being committed on that picket line.’

Q: Can EMAS pay its staff more money and stop the strikes?

A: No. NHS Agenda for Change pay levels are agreed at a national and not at a local level and are therefore are negotiated nationally for NHS employees.


NHS messages for the public

  • Regardless of any strike action taking place, it is really important that patients who need urgent medical care continue to come forward, especially in emergency and life-threatening cases - when someone is seriously ill or injured, or their life is at risk.
  • The NHS will contact you if your appointment needs to be rescheduled due to strike action. Therefore, if you are not contacted, please attend your appointment as planned.
  • GP services are not impacted by this strike action. Please continue to attend your GP appointments, unless you are contacted and told otherwise.
  • If you need medical help or advice, go to NHS 111 online unless it is a life-threatening emergency when you should still call 999.
  • Patients should only call 999 if it is a medical or mental health emergency [when someone is seriously ill or injured and their life is at risk].
  • Ambulances will still be able to respond in these situations, but this may only be where there is an immediate risk to life.
  • There will be fewer ambulances on the roads during industrial action, with the NHS prioritising those with life-threatening needs. As a result patients whose conditions are not life-threatening are unlikely to get an ambulance on strike days.
  • During strike days, it is likely 999 call handlers will be very busy. NHS 111 call centres will have fewer staff, with longer call response times expected across the system. As a result, we are urging anyone with a non-urgent care need to first seek help from NHS 111 online.

For more information on when to call 999and when to go to A&E, you can visit the NHS UK website. 

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