A new report shows 999 call handlers increasingly going off sick and quitting because they feel helpless to help as NHS ambulance waits have increased and they face the brunt of public anger
Ambulance call handlers are going off sick and quitting in droves after bearing the brunt of public anger due to 999 delays and long NHS ambulance wait times.
Data revealed under Freedom of Information laws shows the average 999 call handler takes a month off sick each year – compared to four days for the average UK worker As well as soaring sickness rates, staff burnout is leading to thousands quitting their jobs with one in four leaving last year. Call handlers have revealed the “emotional toll” of 12-hour shifts dealing with people’s “pain”, “fear” and “cries for help”. The findings have been compiled by Unison for a report outlining the impact on frontline 999 staff after a decade of worsening ambulance response times.
One said: “One moment, you’re guiding someone through CPR, the next, you’re handling a major incident, like the recent Liverpool victory parade. There’s a significant emotional impact. It’s relentless. You log in, take emotionally intense calls for 12 hours straight, and then go home.”
Another 999 call handler said: “Typically, those who can’t cope with the intensity of the calls or the distressing screams on some calls tend to leave within a month.” Eleven of the 13 UK ambulance trusts which provided usable responses to a Freedom of Information request reported 166,940 sick days for a combined workforce of 5,084.
This is the equivalent of 33 sickness days per 999 call handler a year. Staff turnover – the percentage of the workforce leaving in any year – averaged 27% since 2021/22. At one trust, South East Coast Ambulance Service, four out of every five call handlers quit their job last year.
The report said: “Often it’s the wider pressures within the NHS that are to blame for some callers having to wait hours for ambulances. Control room staff are often powerless to help.”
UNISON general secretary Christina McAnea said: “These findings paint a bleak picture of the conditions faced by 999 control room staff. TV programmes about ambulance services don’t show things as they really are. Call handlers are under immense pressure, making split-second decisions that directly affect lives.
“They handle relentless calls, often from people in distress, while dealing with complex emergencies and with limited resources. Despite their crucial role, 999 call handlers frequently face emotional strain and operate in an environment where support is sometimes lacking.”
One 999 worker said she had been unable to forget the panic in the voice of a distressed mother whose daughter suffered life-changing burns to her face and body. She said: “Different calls affect people in a variety of ways, and life-or-death situations are particularly tough. CPR calls are difficult but manageable, we’re trained for them.
“Certain calls stay with you. I once spoke to a distressed mother whose daughter had suffered life-changing burns. The panic in her voice is something I’ll never forget. I still think about that poor family.
“But it’s not just the emergencies themselves that stay with you, it’s the way people express their pain, their cries for help, their fears. The job is a whirlwind, requiring quick thinking and resilience. It’s not a career for everyone, but those who take it on deserve proper care and support.”
Another call handler said she had to take time off sick after dealing with four suicide calls in a single shift, an issue that had affected her personally in the past. She said: “As a trainer, the high turnover in the control room has a significant impact on me. I prepare my students to handle intense 999 calls. But unfortunately, call takers are often not treated with respect by the public.
“I have had to take a few days off sick after particularly difficult shifts, especially when I handled multiple calls about an issue that had personally affected me in the past. At first, I thought I was fine, but I wasn’t. Some colleagues have been off sick for months due to stress and the challenging work environment.”
Others talked about occasions where supervisors had failed to check whether staff needed time to recover after having to make life and death decisions for hours on end. Another call handler added: “It’s an incredibly demanding job, no two calls are the same, and no two days alike. But it’s not all bad. Many call handlers also experience rewarding calls, where they genuinely feel they’re making a difference.”
Ambulance response time rose steadily during the last decade, peaking at over an hour and a half for a Category 2 call in December 2022. These are calls including for suspected heart attacks and strokes which the NHS constitution says should take no longer than 18 minutes. Latest NHS England data shows the average in England was down to 27 minutes and 25 seconds in September.
Unison will highlight the welfare of 999 call handlers at the union’s annual conference in Liverpool from Tuesday. Ms McAnea added: “The job is rewarding, but the challenges behind the scenes are far greater than most people realise. It’s bad for morale and for patients when so many staff quit or are burnt out.
“Callers who dial 999 need to know the person picking up the phone is ready to deal with their crisis. Ambulance employers must do more to protect the health and wellbeing of staff who provide such high stakes support. This would help create a more stable emergency service that can retain the skills and experience of emergency call handlers, and persuade people to stay in the job for longer.”
The report stated: “Core qualities of a 999 call handler include empathy, quick decision-making and the ability to remain calm. But that’s hard to maintain when some staff say they are overwhelmed by the emotional toll of the job and sometimes feel unsupported by their managers.”
It continued: “When there’s waits and delays, patients and relatives can often take out their frustrations on ambulance staff. But whatever the situation, no one should have to deal with abuse at work.”
An NHS spokesperson said: “999 call handlers play an essential role as the first point of contact in emergencies and the NHS is taking steps to help staff deal with record levels of pressure including providing a range of health and wellbeing support. But we know there is more to do and the health service is committed to tackling burnout by continuing to offer more flexible working options.”