People experiencing less serious health symptoms are being urged to visit a GP or pharmacy, or use the NHS111 telephone advice service instead of dialling 999, during Wednesday’s ambulance strike. NHS bosses have warned patients that ambulances will take even longer than usual to arrive and that some people may have to make their way to hospital themselves rather than wait for paramedics. Thousands of ambulance staff in England and Wales who belong to the Unison or GMB unions will stage the second stoppage of their dispute with ministers over pay. However, NHS bosses fear this strike will be more disruptive than the first, which took place on 21 December, because it will involve more staff, including call handlers. “The picture will vary across the country, but with more staff expected to strike this time, the NHS is in an even more precarious position,” said Miriam Deakin, the director of policy and strategy at NHS Providers, which represents health service trusts. She said trust leaders were doing what they could to minimise the impact of the strike but were “braced for another day of significant disruption”. They were resigned to thousands of patients having their surgery or outpatient appointments postponed, causing “a knock-on effect on services in subsequent days”, she said. The impact would be “harder to absorb” than last month. Deakin has previously emphasised that NHS bosses “understand completely why overworked ambulance staff have been driven to strike”, and that ministers need to engage with the unions in serious pay negotiations to avoid further stoppages. A third ambulance strike is due to take place on 23 January. Daniel Elkeles, the chief executive of the London ambulance service (LAS), said some people dialling 999 would not get an ambulance at all because so many of its crews would be on picket lines. “There will be fewer ambulances on the road, and fewer staff in our control rooms answering and assessing 999 calls,” he said. “This means some people will have longer waits and some people won’t get an ambulance at all.” People should only request an ambulance “when a life is at risk”, Elkeles said. Some patients could be advised to arrange alternative transport to get them to hospital. NHS England advised patients to use GP services and pharmacies as much as possible because ambulance services would be prioritising the most urgent cases. “Where safe and appropriate, some may be asked to make their own way to hospital, although it is important that they get medical advice from 111 or 999 before doing so,” it said.