Responding to NHS England's letter to NHS leaders on industrial action in ambulance services, NHS Providers' interim chief executive Saffron Cordery said:

"Leaders across the NHS are doing everything they can to ensure safe care for patients and to minimise disruption as they face the daunting prospect of strikes by nurses and ambulance workers next week.

"But with local discussions between trade unions and ambulance trust leaders over which services will be exempt from strike action likely to go down to the wire, widespread disruption across different ambulance services now looks inevitable.

"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.

"And while no trust leader wants to reschedule or cancel planned operations and procedures, we have seen from this week's nurses' strike that this may need to happen to ensure patient safety is maintained and that staff can be redeployed across emergency and critical services.

"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."