Published on: 23 December 2022

This is a message from the partners of the Joined Up Care integrated care system, issued on 23 December 2022. For the latest position, visit the news section of the Joined Up Care Derbyshire website.

The Derbyshire health and care system has taken the decision to stand down the critical incident that was called earlier this week.  This is after identified actions had been deployed and had seen reductions in pressure in some services. Services remain under sustained and significant pressure, and patients and members of the public continue to be asked to use services wisely to ensure those patients with the greatest need can access care and support.

The critical incident was called on Tuesday 20 December due to the significant and sustained demand for urgent and emergency care services.  This was to help clinically prioritise care and maintain safe services for patients. During the critical incident period, some ambulance service workers took part in industrial action called by the GMB union (there is an update on the EMAS industrial action scheduled for next week at the end of this message).  The significant winter planning, and additional planning for coping with strike action, has ensured the NHS has remained open for business and been able to care for patients with greatest need.

Dr Chris Weiner, Executive Medical Director for NHS Derby and Derbyshire, and strategic gold commander for the incident, said:
"Services will continue to prioritise patients with the highest level of need and ensure that we can safely manage emergency care.  We are still facing significant pressure across the health and care system, although this has reduced somewhat since Tuesday and enabled us to stand down the critical incident.

"Despite an improvement in waiting times for ambulances, hospital bed admissions and discharges, staff at the front line remain under significant and sustained pressure in their efforts to provide safe care. We are grateful to everyone who has taken steps to help relieve the pressure, and continue to praise our incredible teams across the health and social care sector for their efforts in keeping our citizens safe.

"We do have ongoing concerns about the forthcoming Christmas Bank Holiday weekend, and the potential wave of stored-up health needs that will present to services on Wednesday 28 December, once the Bank Holiday period has ended. The message is clear: the NHS remains open for business, please do not store up care needs and continue to contact the NHS if you have a health concern.  NHS 111 online can help you with symptom checking and guide you to the right service.

"Despite the pressure, we are very proud that we have been able to maintain the vast majority of operations and procedures planned for this week. Some patients have waited longer than we would like for their procedure, and we have been determined to avoid having to cancel care for these patients.  We know it can be a worrying time ahead of surgery, and we want to reassure everyone on lists that their care is a priority for us."

Health and care services continue to work together to manage the pressure, and there remain a range of steps everyone can take to help:

What members of the public can do to help

Our teams continue to work exceptionally hard and we would like to reassure our patients and the public that despite the challenges faced, essential services remain fully open for anyone who needs them so if you require urgent medical help, you should continue to come forward.

Other things which everyone can do to help the NHS right now, include:

  • Only call 999 or attend accident and emergency departments for serious accidents and for genuine emergencies.
  • When needing urgent medical care but it’s not an emergency, visit NHS 111 online or call NHS111 for advice on how to get care at any time of day or night.
  • Urgent treatment centres/Minor Injury Units – these are available 8am-8pm Derby, Ilkeston, Ripley, Darley Dale, Buxton, Lichfield and Tamworth and can help with care and treatment for many of the most common issues that people attend emergency departments for. They will often be able to help get the care needed more quickly than accident and emergency departments if suffering from things like a burn or a sprain and can also treat fractures.
  • For other non-urgent cases when needing medical advice and it’s not an emergency, speak to your GP practice or a pharmacist.  Try to avoid contacting your GP practice for a condition that will be self-limiting, such as a cold or other virus.
  • Please continue to treat all NHS and care staff with the respect they deserve. Our hard-working staff and volunteers are doing all they can to keep patients safe and supported.
  • If unable to make any NHS appointment, please contact the number on appointment letters so that it can be reallocated to another patient.
  • Check on neighbours and friends and family who has have an existing respiratory condition, to ensure they are okay and not suffering from additional wheeziness or shortness of breath following the heatwave.  Ensure they are following their care plan with medication, inhalers and oxygen support, and contact NHS 111 to seek clinical advice. It is essential that they receive treatment early and seek to prevent an admission to hospital.

There is a range of other steps the community can take at this time help the NHS, and further information is available at

What we are doing:

Health and care services continue to work together to resolve the situation.  Measures we have taken to help manage and alleviate pressure have included:

  • Maximising all available and appropriate hospital capacity to provide beds in which to care for our patients
  • Taking additional steps to release patients from the care of ambulance crews to enable them to get back on the road to see the next patient, including extra capacity in ED and extra consultants on hand to assess the clinical needs of patients on arrival, with the aim of turning crews around in no more than 15 minutes from arrival
  • Diverting all clinically-trained staff to provide direct care and support, and cancelling all non-essential training
  • Opening more than 40 additional community-based beds to support discharge from acute hospitals.

We will continue to prioritise patients in order of clinical need to ensure that we can manage emergency care.  We are working hard to protect planned appointments and operations for patients who have an urgent need or have already waited a long time for their procedure.  Please continue to treat all NHS and care staff with the respect they deserve. Our hard-working staff and volunteers are doing all they can to keep patients safe and supported.

Industrial action at EMAS – update

The GMB trade union has today informed its members that it has cancelled the industrial action scheduled for 28 December 2022. Instead, strike action is now scheduled for 11 January 2023.

For more information, please see Industrial action at EMAS - update | East Midlands Ambulance Service NHS Trust