The Ambulance Service Association's members don't balk at more millennium planning - they seem to relish it. Laura Donnelly reports

Few would dare to suggest that the NHS doesn't have its millennium planning in tip-top shape. For one thing, its glossy communications machine regularly tells us not to panic.

But if those charged with actually running hospital and primary care services on the big night are still looking for inspiration, they could do worse than turn to colleagues in the ambulance service.

Last week a giant game of 'let's pretend' saw 70 senior ambulance managers bat off staff absenteeism, capacity overload, staff at the sharp end of violence and technical failures on millennium eve. Oh, and a spot of law and order breakdown for good measure.

Some might have panicked. But not Ambulance Service Association members. They are offering solutions where lesser mortals couldn't spot problems - at the last of seven events on year 2000 planning.

What if control centres are faced with overload? Kent Ambulance trust emergency planning officer Frank Stocks is negotiating with BT to extend routine call-waiting times while David Williams of Royal Berkshire Ambulance trust plans to bring in extra call handlers and train up administrative staff. Others intend to install a public health doctor in control centres to speed up triage.

What if fuel pumps turn out to be non-compliant, challenged rapporteur John Underwood. A flurry of ideas ranged from back-up manual systems to local agreements with fire services, airports and the legal obligations of motorway service stations.

There were contingency plans to back up contingency plans. In London, 'concerns' that the 20 per cent of petrol stations open would not provide the support promised had been taken to the top at BP - resulting in a 'complete change of attitude' and guaranteed extra services.

And if the media turned on hardpressed services? Perhaps inspired by Mr Underwood's assurance that 'there is no act of Parliament which says we have to answer in the terms in which the question is framed', members spun disaster into triumph.

In fact, it seemed the service could handle anything - until they were questioned about how they would staff the night.

Most services have cancelled all annual leave and were confident that staff would be there. But in the capital - the focus of three major celebrations and an anticipated 9 million visitors - the picture is more uncertain.

London Ambulance Service trust has not cancelled leave. Emergency planning manager Laurie Strugnell blamed 'industrial relations problems' for the failure to take the step. The 'real doubt about whether people would come to work' under duress means the number of staff rostered to work overnight for a£150 bonus matches a normal daytime quota.

But how could the LAS defend itself if things aren't alright on the night? 'It is a tremendous problem, and one we have looked at very carefully, ' said Mr Strugnell, stressing his personal view that a ban on leave ran the risk of inciting staff to 'vote with their feet'.

As members focused on a series of events unfolding in the county of 'Ficshire' they revealed very different expectations of the demand they were likely to face back home.

Kath Hughes, information manager at Cumbria Ambulance Service trust, said she had not been informed of any major events. But East Anglian Ambulance trust knew of three local events covering 100,000 people, and 210 smaller parties.

Assistant chief constable Ken Jones, a member of the Association of Chief Police Officers' millennium committee, warned managers that unlicensed events - such as raves - were likely to provide more problems than major planned events. He told HSJ that managers would be 'naive' to expect the number of gatherings to match those on events databases.

And success in tackling the issue would demand 'integration to a degree not experienced before'.

It was a view echoed by millennium winter forum chair David Griffiths, chief executive of Sussex Ambulance Service trust. He told HSJ he was impressed by the honesty and maturity of members.

'You can talk about collaboration in the NHS until you are blue in the face.

But to me it is being able to say, 'I need your help. Tell me what you would do.'

And that is what happens here.'