The urgent and emergency care system is experiencing a significant increase in pressure this week driven by the recent changes in weather and related presentations. London Ambulance Service is at Resource Escalation Action Plan level 3 and has moved to Clinical Safety Plan level Red to ensure it can maximise safety and continue to manage the high number of 999 contacts being made each day, reducing the wait for emergency ambulances.

The London region urgent emergency care team requests the following support:

• Not to refer patients to 999 unless it is absolutely clinically necessary or the patient has a life-threatening emergency.
• Not to refer patients to 111 unless the patient has an immediate urgent need and advise patients to use 111 online or to contact their local pharmacist.
• Consider using rapid response teams and other alternative care pathways including pharmacies. Only send for an ambulance if it is an emergency.
• Ensure that non-clinicians are not referring patients to 999 or 111 as an alternative to primary or community care unless it is a life-threatening emergency.

For any queries, email the London region urgent emergency care team.