The public have been urged to be “really helpful” amid ambulance strikes by only calling 999 with life and limb emergencies.

London Ambulance Service (LAS) aims to be able to respond “as normal” to calls about strokes and heart attacks despite industrial action by ambulance workers and call handlers on Wednesday.

An agreement has been reached to have no more than half of staff out on strike in a bid to ensure the most serious calls are answered, LAS chief executive Daniel Elkeles said.

He said the service is expecting an “almost identical” level of disruption as in December strikes when around 200 – or roughly half of – ambulances were available in the capital.

Mr Elkeles said while there is currently “slightly less” pressure in the system than there was just before Christmas, the health service remains very busy.

He told reporters on Tuesday: “It is still really, really busy in the NHS and hospitals are really, really full so I would just ask the public to be really helpful again tomorrow and only phone us if they have a life and limb-threatening emergency.

“And if they have another urgent healthcare need please use 111 either on the phone or online.”

Mr Elkeles said he is “confident” planning for the industrial action will mean people will still get “good care”.

Daniel Elkeles, chief executive of the London Ambulance Service, speaks to the media at the LAS emergency operations centre in Newham, east London
Daniel Elkeles, chief executive of the London Ambulance Service, speaks to the media at the LAS emergency operations centre in Newham, east London (Aaron Chown/PA)

Asked if category 2 calls such as suspected heart attacks and strokes will be answered, he said: “They will. We have called it life and limb conditions because some of them are in category one, some of them are in category two, and actually some might be in category three.

“But what we are clear about is if you are a patient who has a life and limb-threatening emergency, then we will be able to respond tomorrow as normal.”

Mr Elkeles urged people to still call 999 if they have such an emergency.

He said: “Everyone can see the NHS is under considerable challenge in the here and now, and clearly industrial action only adds to those challenges.

Staff working at the LAS emergency operations centre in Newham, east London
Staff working at the LAS emergency operations centre in Newham, east London (Aaron Chown/PA)

“However, I’m confident that with all the planning that we have done, people who have a life and limb-threatening emergency will get good care if they phone 999.

“I would just urge people, if they are having a life and limb-threatening emergency, to carry on phoning 999 as normal.”

Asked about the level of co-operation with unions, Mr Elkeles was positive, saying there had been “really good conversations” with union colleagues.

He said: “What we have agreed with our union, Unison, is that a maximum of 50% of the staff will be taking industrial action at any one time, and if our call-answering time takes too long then staff will come from the picket line back into answering the phone, so that we can know that we can provide life and limb-threatening cover which is what we have agreed with our union is what we will do tomorrow.”

Asked about his understanding of or support for ambulance workers going on strike, Mr Elkeles said: “Of course I support people’s right to go on strike and the Government have said that even in the Bill that they’ve just laid before Parliament today. The cost of living is clearly a very big issue and I think everybody can see that.”

Pressed on whether he understood why they are going on strike, he said: “I think it is clear from what the unions have said as to why they believe there is an issue that needs to be resolved, yes.”

An ambulance wait time screen on display at the LAS emergency operations centre in Newham, east London
An ambulance wait time screen on display at the LAS emergency operations centre in Newham, east London (Aaron Chown/PA)

Business Secretary Grant Shapps told MPs on Tuesday that the ambulance strike involving tens of thousands of staff in England and Wales underlined the need for legislation on minimum service levels.

Speaking about the Strikes (Minimum Service Levels) Bill in Parliament, he said the Government would consult on what an “adequate level of coverage” would be in fire, ambulance and rail services.

The proposals have been condemned as unworkable and illegal by unions, who warned they would “poison industrial relations” and lead to more walkouts.