More than a quarter of NHS ambulance call handlers have left their roles in the past three years, according to a new report from Unison. The union warns that growing stress, burnout, and illness are driving staff away—and putting patient safety at risk
A new report by Unison reveals that 11 of the 13 UK ambulance services experience high turnover rates among 999 call handlers, which staff attributed to a lack of support and the non-stop, often distressing calls that frequently lead to sick leave. Last year, the South East Coast Ambulance Service had the highest staff turnover rate (80%), followed by the North East (33%), Yorkshire (31%), and South Central (28%).
NHS 999 call handlers are quitting and suffering burnout because of the relentless pressure of calls, sometimes involving suicides, stabbings, shootings, and patients dying before ambulances can reach them.
High staff turnover and increased sickness in the last three years
The report, launched at the union’s annual conference in Liverpool today, highlights the pressure on 999 call handlers, with 27% of NHS ambulance control staff quitting their jobs over the past three years.
Additionally, more than half a million days were lost to call handler illness in the three years from April 2021. The figure for 2023/24 alone was 166,940 – the equivalent of more than a month of sick leave for each 999 call handler. This compares with just four days on average for UK workers.
The union says high staff turnover and increased sickness absences are having a negative impact on patients. It often means people have to wait longer for 999 staff to answer calls or for their emergency to be adequately assessed and dealt with.
The psychological toll of handling call after call with few breaks
Unison interviewed emergency 999 call handlers for the report, who described the psychological toll of taking call after call. Staff would often work 12-hour shifts with limited breaks while dealing with complex emergencies such as mental health crises.
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.
Another 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.
Others talked about occasions where supervisors had failed to check whether staff needed time to recover. This is despite 999 call handlers having to make life-or-death decisions for hours on end.
Unison is calling for improved emotional support for 999 call handlers
UNISON is calling for better training, regular breaks during shifts and improved emotional support. Call handlers should also be regraded from band 3 to band 4 on the NHS pay scale, says the union. That would mean a starting salary of £26,530 per year, which would give staff a more significant financial incentive to stay and better reflect the work they do, says the union.
Commenting on the figures, UNISON general secretary Christina McAneasaid: “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 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.
“The job is rewarding, but the challenges behind the scenes are far greater than most people realise. It’s detrimental to morale and patient care when many staff members quit or become burned 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.”
