Elective activity should only be reduced “as a last resort” during ambulance strike action next week, NHS England has told trust leaders.

In a letter published today, NHSE officials confirmed “extensive disruption” is expected when GMB union, Unison and Unite members walk out in a dispute over pay on 21 December (Wednesday).

It told acute, mental health and community trusts to ensure ambulance handovers were completed within 15 minutes following arrival, with plans for this to be reported to NHSE by 4pm on Monday.

The letter comprised a list of “essential actions” for different sectors, as acute, community and mental health trusts should only consider reducing elective activity “as a last resort”.

It added: “However, trusts may wish to consider stepping down some physician-led outpatient activity in relevant specialties in order to allow redeployment of senior physicians to EDs to assist with decision making, additional ward rounds and discharge in advance of industrial action, as well as supporting timely ambulance handovers in preparation for and during days of industrial action.”

NHSE said the rescheduling of urgent cancer diagnostics or cancer treatment should only be considered “if all other options have been exhausted and every other effort should be made to maintain these appointments”. 

It said that in relation to the Royal College of Nursing second strike day on 20 December, the union had clarified that clinically urgent treatment should continue, but must be agreed upon locally on a “patient-by-patient basis”.

The letter was signed by Sir David Sloman, NHSE’s chief operating officer; Sir Stephen Powis, NHSE’s national medical director; and NHSE’s chief nursing officer Dame Ruth May.

Industrial action is expected to affect nine out of England’s ten ambulance trusts on the first day before GMB members walk out on 28 December, impacting eight ambulance trusts too.

This will come a day after the Royal College of Nursing stages its second day of strike action over pay and safety concerns, with more possibly expected after Christmas.

HSJ revealed a deal has been agreed upon between the GMB and the South East Coast Ambulance Service, but crucial derogations at other trusts are still yet to be confirmed.

Sir Jim Mackey, NHSE’s elective recovery chief, said this week that the ambulance staff strike represented a “completely different order of magnitude” to the nurses’ strike.

However, he told a King’s Fund conference that a blanket ban on electives would only be used as an “absolute last resort”.