Unite the union, the GMB and Unison have called on bosses at the North West Ambulance Service (NWAS) NHS Trust to change the procedure, known as EOC0001, which sees any ambulance within 40 minutes being immediately assigned for category two calls.
The calls are classed as an emergency for a potentially serious condition that may require rapid assessment, urgent on-scene intervention and/or urgent transport.
The Royal College of Nursing (RCN) also expressed "deep concerns" about the deployment procedure.
The three unions will now hold a consultative ballot of their members in the next month to see if they want to have a full-scale industrial action ballot, including the option to strike - after accusing the trust management of "failing both patients and staff."
With NWAS services covering the entire North West region, the system can often mean ambulances driving for miles in "blue-light conditions" for catergory two calls, only to then find themselves relieved by a more local ambulance team.
There are an estimated 4,500 to 5,000 999 calls to the trust every day – more than half of which are identified as category two.
Neil Cosgrove, Unite branch secretary, said: "We are hearing of crews driving 40 minutes, under emergency conditions which is hazardous at any time, and then to be sent somewhere else and drive for another 40 minutes. This can be repeated several times in one shift.
“The ambulance crews are seeing and treating fewer patients, but driving for longer times and further distances.
“For some time, Unite has raised serious concerns with the management about the way in which these changes have been introduced and are now currently operating.“They are having a significant adverse impact on our members’ physical and mental health and welfare, as well as posing a significant risk to patient care. This is no longer acceptable.
"In essence, there are not enough ambulances and staff to meet the ever-increasing demand."
Unite regional officer Gary Owen added: “We are working closely with the GMB and Unison, as well as the RCN, to address this serious issue which is caused by a lack of funding, and shortage of ambulances and trained crews.
“Our members, who have been in the Covid-19 frontline for the last 16 months, are feeling drained by these long journeys which can be called off if a local crew suddenly becomes available.
“Hopefully, the trust enters in constructive talks before such a ballot is held. Unite’s door is open for such negotiations 24/7.”
NWAS Trust said the procedure has been in place for over a year, and was implemented to prevent patients from waiting too long for an ambulance response.
Chris Grant, Medical Director for NWAS, said: This procedure, known as EOC0001, has been in operation for over 12 months and allows ambulance crews to travel up to 40 minutes to attend a category 2 incident - these are serious, but not immediately life-threatening incidents including strokes, seizures and burns.
“However, due to a significant increase in 999 calls, we have recently fully implemented the procedure, as these patients are frequently waiting longer than they should for a response.
“All our patients need us to reach them as quickly as we can during their time of need, if local crews aren’t free, when there are available resources just that little bit further away or out of the area – we feel we should send the closest resource we can.
“So far, the results are positive as we have seen fewer reported Serious Untoward Incidents (SUIs) within this category.
“However, we recognise concerns raised by staff and trade union colleagues about the longer travelling times. As a result, discussions were held this week about amending the policy, and a lower 30 minute time has been agreed with the trade unions.
“We’re are currently not aware of any formal announcement for a ballot for strike action by the unions, although negotiations are still ongoing.”
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