Thousands of NHS workers are preparing to go on strike this winter amid fears armed forces personnel could be brought in to drive ambulances and take on frontline hospital roles.
Health and defense officials are drawing up a contingency strategy as ambulance drivers and paramedics vote to join nurses on picket lines in the coming weeks.
Nurses are set to walk out in December, while unions including Unite, which represents 100,000 NHS workers, are polling members from the health service.
In total, more than 850,000 NHS staff members have either been voted in or are expected to take strike action over pay, including nurses, junior doctors, midwives and those working in blood and transplant services.

Armed forces personnel could be brought in to drive ambulances and take on a frontline hospital role amid fears thousands of NHS staff could go on strike

Members of the Royal College of Nursing (RCN) in England, Wales and Northern Ireland will walk out on December 15 and 20 if a pay dispute is not resolved.
As pressure mounts on an already record backlog in NHS waiting times, the government could use the Military Aid to Civil Authorization Protocol (MACA) to keep key services running, The Times has reported.
Maca was used during the coronavirus pandemic to help distribute vaccines, tests and protective equipment to struggling health workers.
No formal request for help has been made by the Department of Health and Social Care to the Ministry of Defence.
Health Secretary Steve Barkley said he ‘deeply regrets’ the nursing staff walkout, but added that their demands – a 19 per cent pay rise – were ‘not affordable’.
Members of the Royal College of Nursing (RCN) in England, Wales and Northern Ireland will walk out on 15 and 20 December if the dispute is not resolved.
They have promised emergency security and immediate care during the 12-hour strike.
However, the strike is still set to affect about half of hospitals, potentially postponing 30,000 operations and hundreds of thousands of outpatient appointments.
It comes as NHS bosses warned the health service faces the ‘most challenging winter ever’ with a ‘tripledemic’ of flu, Covid and record demands on urgent and emergency services.

Maca was used to help distribute vaccines, tests and protective equipment to struggling health workers during the coronavirus pandemic
A government spokesman said: ‘We are working with the NHS on a range of options for managing disruption to health and care services during industrial action.
‘Hospitals will do everything they can to keep patients and the public safe, however planned appointments may need to be canceled and emergency care may be given priority to only those requiring urgent care.’
The nurses’ strike next month will be their first UK-wide action, and they will join transport and postal workers on the picket line over pay and conditions disputes.
Health Secretary Steve Barclay has urged the nursing union to ‘get back to the table’ for talks, but he has refused to discuss pay, instead talking about terms such as pension arrangements, holidays, rosters and the availability of free coffee are doing.
RCN general secretary Pat Cullen wrote to Mr Barclay that it was ‘negotiations or nothing’.

The NHS waiting list for routine operations in England breached 7 million for the first time in August. This includes around 390,000 patients who have been forced to wait for more than a year for treatment
The strike looks unlikely to be called off before Christmas, as Transport Secretary Mark Harper said increasing public sector wages in line with rising inflation was ‘unsustainable’.
The cabinet minister said there is “simply no money” to meet the demands of workers preparing to take industrial action but hinted at progress in talks on rail strikes.
Mr Harper signaled a change in the mandate for talks and said a pay rise would come if rail workers accepted the reforms, after holding ‘positive’ talks with Mick Lynch, general secretary of the Rail, Maritime and Transport (RMT) union. Can
Mr Harper told Sky’s Sophie Ridge on Sunday’s programme: ‘Inflation-matching or inflation-beating pay rises are unsustainable.

All major health unions have either voted or are set to vote on a walkout, meaning thousands of NHS workers could go on strike in the coming months
‘I think we want to try and give all employees in the public sector who work very hard, but they can’t be inflation-busting pay rises.
‘There is no money to pay for references, we haven’t even seen them in the private sector, private sector salary hikes are generally fixed below the level of inflation, which I accept is It’s difficult for people. ,
He told the BBC’s Sunday with Laura Kuensberg that rail bosses would ‘have the ability to reach a deal’, when pressed about whether they had a mandate to negotiate properly with the RMT.
‘But we need to be able to negotiate that reform package, because it is the only one that maximizes savings,’ Mr Harper said.
‘I don’t have a bottomless pit of taxpayer money to throw at this problem.’