The chief executive of an acute trust in the Midlands told the HSJ: “We had a very, very challenged night for handovers last night, possibly the worst ever – and it’s only July.”

The South Central Ambulance Service – which covers Berkshire, Buckinghamshire, Hampshire and Oxfordshire – said that it declared a critical incident on Monday owing to current pressures and there will be delays in responding to patients with “less urgent needs”.

NHS trusts said that many people were struggling to cope with high levels of Covid staff absence, on top of the heatwave.

The HSJ reported that 111 services had also been hit by large numbers of Covid-related absences and high demand, meaning at points over the weekend in London, three in 10 calls were not being answered. 

The South Central Ambulance Service said it had escalated to Reap 4 because of “a rise in Covid infections, as well as other respiratory illnesses, among both staff and in our communities”.

It added that an increasing number of 999 calls and high temperatures were also key factors.

The South East Coast Ambulance Service – which covers Surrey, Kent, and West and East Sussex – escalated to Reap 4 on Monday, saying that the incident was called following “sustained pressure on both our service and wider system”, with hot weather a major factor. 

The HSJ has been told that Covid absences were affecting many of the trusts’ ambulance crews and staff were being offered incentive payments to do extra hours.