A growing number of ambulance services in England say the cold start to the month and outbreaks of illness have created unprecedented levels of calls.
A growing number of ambulance services in England say the cold start to the month and outbreaks of illness have created unprecedented levels of calls.
Some say staff are struggling to cope and are urging people to dial 999 only in a genuine emergency.
Some say staff are struggling to cope and are urging people to dial 999 only in a genuine emergency.
London Ambulance Service said last week was the busiest in its history.
London Ambulance Service said last week was the busiest in its history.
The North West service also reported record numbers of winter calls. West Midlands said staff were working flat out to meet the "extraordinary demand".
The North West service also reported record numbers of winter calls. West Midlands said staff were working flat out to meet the "extraordinary demand".
So far, this December has been the coldest for 30 years in many parts of Britain.
So far, this December has been the coldest for 30 years in many parts of Britain.
'Horrendous'
'Horrendous'
This has caused a sharp increase in falls and breathing problems and has combined with outbreaks of flu and the winter vomiting bug norovirus to create the high level of demand.
This has caused a sharp increase in falls and breathing problems and has combined with outbreaks of flu and the winter vomiting bug norovirus to create the high level of demand.
Ambulance services say this has put pressure on hospital beds, often slowing down ambulances needing to offload patients and move on to attend new emergency calls. Staff are tired and also sickness levels are increasing as they themselves become the victim of the norovirus and other stomach bugs Anthony Marsh, West Midlands Ambulance Service
Ambulance services say this has put pressure on hospital beds, often slowing down ambulances needing to offload patients and move on to attend new emergency calls. Staff are tired and also sickness levels are increasing as they themselves become the victim of the norovirus and other stomach bugs Anthony Marsh, West Midlands Ambulance Service
Peter Bradley, the national director for the ambulance services, told the Daily Telegraph the entire system was "struggling to cope".
Peter Bradley, the national director for the ambulance services, told the Daily Telegraph the entire system was "struggling to cope".
Mr Bradley, who is also chief executive of the London Ambulance Service, said: "It has been the most difficult 10 days I have seen in the last 10 years. It is absolutely horrendous.
Mr Bradley, who is also chief executive of the London Ambulance Service, said: "It has been the most difficult 10 days I have seen in the last 10 years. It is absolutely horrendous.
"Hospitals are full and A and E departments are struggling."
"Hospitals are full and A and E departments are struggling."
People are urged to make use of other health services, such as NHS walk-in centres, NHS Direct and pharmacies, unless their situation is genuinely an emergency.
People are urged to make use of other health services, such as NHS walk-in centres, NHS Direct and pharmacies, unless their situation is genuinely an emergency.
In London, ambulance workers are handling 1,100 calls about "life-threatening" situations every day, a service spokesman said.
In London, ambulance workers are handling 1,100 calls about "life-threatening" situations every day, a service spokesman said.
The total number of calls it is receiving every day has risen in the last few weeks from around 3,000 to nearer 4,000.
The total number of calls it is receiving every day has risen in the last few weeks from around 3,000 to nearer 4,000.
According to the service, the status of the situation has been elevated from "severe" to "critical".
According to the service, the status of the situation has been elevated from "severe" to "critical".
In response, staff are working overtime, all non-essential meetings and transport have been cancelled and training staff have been put back on the road, the spokesman said.
In response, staff are working overtime, all non-essential meetings and transport have been cancelled and training staff have been put back on the road, the spokesman said.
Winter planning
Winter planning
In the West Midlands, 8,000 emergency calls were made last weekend, up 30% on the same weekend last year.
In the West Midlands, 8,000 emergency calls were made last weekend, up 30% on the same weekend last year.
West Midlands Ambulance Service chief executive Anthony Marsh said these were "unprecedented levels" for the service, which covers cities including Birmingham and Coventry and the counties of Warwickshire, Herefordshire, Worcestershire, Shropshire and Staffordshire.
West Midlands Ambulance Service chief executive Anthony Marsh said these were "unprecedented levels" for the service, which covers cities including Birmingham and Coventry and the counties of Warwickshire, Herefordshire, Worcestershire, Shropshire and Staffordshire.
"All staff are working flat out around the region to meet the extraordinary demand and are trying to do their best in very difficult circumstances," he said.
"All staff are working flat out around the region to meet the extraordinary demand and are trying to do their best in very difficult circumstances," he said.
"Staff are tired and also sickness levels are increasing as they themselves become the victim of the norovirus and other stomach bugs that are around."
"Staff are tired and also sickness levels are increasing as they themselves become the victim of the norovirus and other stomach bugs that are around."
He said people were still dialling 999 for non-emergencies, meaning staff were arriving at people's homes to find they did not need the blue light service at all.
He said people were still dialling 999 for non-emergencies, meaning staff were arriving at people's homes to find they did not need the blue light service at all.
A spokesman added that at one hospital, Hereford County, over the weekend, he saw eight ambulances queued up outside waiting to off-load their patients.
A spokesman added that at one hospital, Hereford County, over the weekend, he saw eight ambulances queued up outside waiting to off-load their patients.
He said it was a similar picture across the region.
He said it was a similar picture across the region.
Over the weekend, the North West service, which serves Merseyside, Lancashire, Cumbria and Greater Manchester, said the number of calls it had received so far this winter was higher than ever.
Over the weekend, the North West service, which serves Merseyside, Lancashire, Cumbria and Greater Manchester, said the number of calls it had received so far this winter was higher than ever.
A Department of Health spokesman said the NHS was used to planning for winter and this year was no different.
A Department of Health spokesman said the NHS was used to planning for winter and this year was no different.
He said letters has been sent in October to all strategic health authorities and social services to remind them of the need to make sure winter plans were firmly in place.
He said letters has been sent in October to all strategic health authorities and social services to remind them of the need to make sure winter plans were firmly in place.
He added that the department also had a dedicated winter team to support the local NHS.
He added that the department also had a dedicated winter team to support the local NHS.
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