Last winter, I spoke to a paramedic who had just spent an entire overnight shift – 12 hours, plus an extra two and a half – with one patient. This wasn’t a lengthy extraction of a person from car wreckage, or some kind of marathon CPR session on the scene. It was an elderly patient who had fallen and broken their hip, lying in the back of an ambulance in the hospital car park, from 6.30pm until 9am.
All the while, the paramedic was hearing calls coming in on her radio – the control room asking her to respond to category one cases, the most life-threatening. She could not respond to any of those patients who needed her because she was stuck with her patient, waiting for a bed in a full emergency department. More than 11,000 ambulances a week are waiting in queues of at least an hour outside A&E units in England, according to the latest figures. The handover time should be 15 minutes.
Every time my source and her colleagues were unable to respond to a 999 call, she said they suffered a “moral injury”. It’s a phrase that has stuck in my head since we spoke. As labourers risk physical injury, health workers are suffering from damage to their consciences. The working conditions for front-line NHS staff are high-pressure, emotionally draining and physically exhausting – but they are now morally dangerous too.
This is why it makes no sense to oppose strikes by nurses, paramedics and 999 call handlers on the grounds of patient safety. More than 10,000 ambulance workers have voted to go on strike, joining 100,000 nurses planning to walk out this month, and following the first act of industrial action by emergency call handlers in October. Of course, patients will feel the impact and waiting lists will grow. But if health workers don’t make a drastic statement about the risks posed by a lack of staffing, levels of burnout and stretched resources, then patients – like all those people calling 999 during that one 14-and-a-half-hour shift – will also struggle to be heard.