1/14 Attention has focused on hosps in coverage of #NHS response to #coronavirus. Mustn't overlook contrib of #mentalhealth, community and ambulance staff, responding to huge challenges. I’ve talked to amb leaders about pressures they face as we head into peak demand period.

2/14 Should make it clear we’re not the government or @NHSEngland we are voice of NHS trusts. I’m not a clinician and haven’t/don’t work on frontline. You can find full details of basis of our public coronavirus comment here https://nhsproviders.org/news-blogs/press-office

3/14 Ambulance trust leaders clear about importance of protecting and looking after staff. That includes securing supplies of PPE and key role of guidance on how it’s used.

4/14 PPE supplies more of an issue in some areas than others. Particular concerns re coveralls and visors - though overall national supply is sufficient and ambulance leaders say staff have access to the protection they need to keep the public safe.

5/14 Some continuing concern over PPE guidance though recent clarification – which goes further than WHO recs on some issues – has helped. Reassuring too that this is being kept under constant review by experts working with national ambulance lead.

6/14 Another key concern is over staff testing. Large numbers off work – hundreds in every ambulance service - either have or live with someone with covid symptoms – though many off as a precaution are asymptomatic.

7/14 This underlines the vital importance of testing. Need to get up to that 100,000 figure by the end of the month. Crucially though, ambulance leaders say the figures need to be going up from now rather than big surge in late April.

8/14 Interesting in north east they started staff testing earlier thanks to great work @NewcastleHosps and @QEGateshead – kept staff sickness down at c14% - lower than others.

9/14 Ambulance leaders say staff coping well under extraordinary pressures given levels of demand and sickness – though again, not a uniform picture. Some were in stronger position than others to face this challenge.

10/14 And ambulance leaders have to push to ensure their sector is heard amid other priorities, eg thinking through ambulance deployment implications of establishing Nightingale hospitals.

11/14 Key priority for amb ldrs is 999 resilience- important lessons from London's early spike in demand – being prepared at call centre, despatch and frontline, ready for high sickness/MH pressures, Covid + non-covid activity. Important preps for winter rolled over into covid.

12/14 Early moves to increase/upskill staff paying off – drawing on student paramedics and patient transport services to strengthen frontline, extra 999 control staff, corporate staff + local GPs supporting call handling Also egs of military/firefighters driving ambulances.

13/14 Another challenge has been ensuring safe environment for call centre staff with 2 metre distancing. Creating space for call handlers through increased homeworking for corporate staff.

14/14 Amb ldrs - biggest worry for staff is personal exposure/fear carrying covid to family. Need all their resilience to lk after pts. So getting PPE + testing vital, + recog from politicians/other NHS ldrs of huge contrib of amb svice- whole team wking flat out to save lives.