More than 500 emergencies were waiting for a response from East Midlands Ambulance Service (EMAS) when it declared a critical incident on Monday (January 6).

Bosses felt there was "a great risk" of patient harm and they had to "take action" to reduce this last night.

The trust, which covers the whole of the East Midlands, also told the Local Democracy Reporting Service that around 200 staff hours were lost outside of the A&E department at Leicester Royal Infirmary yesterday due to delays in patient handovers.

The delays and high demand, along with widespread flooding slowing down crews, added to pressures already being experienced by the trust, pushing it over the edge.

The critical incident remains ongoing today (Tuesday, January 7) and will be reviewed this afternoon, director of operations at Emas Ben Holdaway said. It will not be stood down until local healthcare bosses are "absolutely sure" the situation has returned to "some kind of normality". Mr Holdaway said it was "not possible" to predict when this might be.

Declaring a critical incident allows the trust to call on other healthcare partners, including hospitals and integrated care boards which oversee healthcare in an area, to take "immediate action to help mitigate the risk for people".

This includes the rapid release of ambulances from outside A&E departments, some calls being redirected for assessment, and Clinical Hubs taking on patients who ring Emas and are classed as category three – calls which are considered urgent but not life-threatening.

However, patients also have a role to play in easing pressures on the service. When asked if he had a message for residents, Mr Holdaway said: "Please only call 999 if you believe yourself to be in a life-threatening situation.

"Please look at pharmacies, NHS 111, contacting your GP for example. And if you do call, it's likely there will be a delay in us getting to you, please only call back if you believe that the condition of yourself or your or the patient you're with has deteriorated.

"It doesn't speed [the service] up by you ringing us back to see where the ambulance is. Our staff are working tremendously hard, both within our emergency operating centres and in the operations to get to patients as quickly as we possibly can.

Photo: Coalville Nub News

"By doing those things that will support the staff who are working incredibly hard, doing a fantastic job to get the patients as quickly as possible."

He also expressed his thanks to Emas staff, saying: "We're just extremely grateful for the hard work that they do. It's been a very busy winter so far. We've just come through the Christmas and New Year period when they will have been on duty while others have been celebrating. We're just really thankful for the hard work they continue to do to, to try and get to patients as quickly as they can."

Pressures facing the service are nothing new, however. The trust upgraded its action plan to level four – the highest level – in late November. Level four warns of the "potential for failures within the service" as a result of pressures on it.

The LDRS asked Mr Holdaway what he believes needs to be done in the longer term, both locally and nationally, to help ease this strain. He said a "whole system approach" is needed to help find solutions.

This could be through changes to the ways people access healthcare, including more doctors appointments, and changes to social care set ups to enable patients to be discharged from hospitals "in a timely manner".

On what he feels the Government should be doing, Mr Holdaway said he would be waiting with "interest" to see how ambulance services "fit into" its long-term plan for the NHS.

The LDRS also approached the University Hospitals of Leicester NHS Trust this morning to ask how the Emas critical incident would impact local hospitals and whether they too were experiencing similar pressures. Responding on behalf of all local healthcare services, a spokesperson from the Leicester, Leicestershire and Rutland (LLR) integrated care board, which oversees services, said: "NHS partners have been supporting EMAS with their critical incident and have been working alongside other East Midlands Providers throughout the day and night, putting in place additional measures to ensure Ambulance crews are able to respond to the needs of our communities.

"This morning, an LLR system response continues to be in place, including additional support from our GP and local authority partners, to ensure that all available capacity is used and that patients at ED and in the community are kept safe. Our local health and care system will continue to support EMAS, ensuring patient safety is prioritised at all times."