HSE contingency plans for National Ambulance Service industrial action

1. Advice to the public

The HSE has a contingency plan in place to prioritise patient safety and minimise disruption for the public in response to the industrial action being taken from today by members of the SIPTU and Unite trade unions in the National Ambulance Service (NAS).

SIPTU and Unite members are to impose a work-to-rule today (11 May 2026), and a 24-hour work stoppage tomorrow (12 May 2026) as part of a set of rolling actions. During the rolling industrial actions, the capacity of the NAS to respond will be significantly impacted. All other health services are operating as normal, and if there is any change to your planned care you will be contacted.

During this period of industrial action, any member of the public should contact 999 or 112 if someone is experiencing a life-threatening illness or injury. The 999-phone service is fully operational and under the HSE’s contingency plan, priority will be given to patients facing emergencies such as cardiac or respiratory arrest, and those experiencing serious trauma such as that arising from road traffic accidents.

If you need urgent medical care, consider all healthcare options, and if you are unsure on what to do call 999 or 112. There will be delays in responding to non-life-threatening calls. Alternative healthcare options include:

Injury Units

These treat non-life-threatening injuries such as broken bones, dislocations, sprains, wounds, scalds, and minor burns. No appointment is required; patients can attend directly. You can find your local injury unit here.

Your local pharmacy

Community pharmacists provide expert advice and over-the-counter treatments for a wide range of minor illnesses.

GP and GP Out-of-Hours Service

If you urgently need to see a GP outside of regular opening hours, you should contact your local out-of-hours GP service.

Mental health supports

Information about when to get help, organisations that provide mental health services and types of specialist services are available here.

2. The dispute

The HSE regrets the decision of SIPTU and Unite to proceed with industrial action. This action is to begin with a work-to-rule today (11 May 2026), and a 24-hour work stoppage tomorrow (12 May 2026). Patient safety, and minimising public disruption, are the priority for the HSE.

The HSE and State have engaged with the recognised trade unions representing NAS operational staff (SIPTU and Unite) intensively over the past two years under the auspices of the Workplace Relations Commission (WRC). A set of independently brokered proposals aimed at resolving the dispute, and all others matters in dispute including pay and service transformation were agreed and recommended to their members by both SIPTU and Unite. The implementation of the timing of the significant increases in pay was also the subject of a Labour Court recommendation.

In July 2025, the HSE and Government accepted both the WRC proposals and the Labour Court Recommendation, demonstrating a clear resolve and determination to address the current dispute.  These proposals included 3–14% pay improvements, on top of 9.25% under the PSA, linked to agreed reforms. In September 2025, SIPTU and Unite informed the HSE that the proposals independently brokered by the WRC, supported by a Labour Court Recommendation, and recommended by both trade unions had been rejected by their members.

Over the period 2022- 2025, NAS has been the focus of a major transformation and investment programme to strengthen service delivery, improve patient safety, and expand alternative and community-based care. This includes:

A 41% increase (€83m) in the NAS base budget to €285m

A 28% increase in staffing, with 588 additional WTEs, bringing total staffing to 2,655

€126m investment in fleet replacement and expansion

NSP for 2026 includes significant additional investment in the order of €20m new revenue funding, including 263 additional staff, bringing the total funded complement for 2026 to 2,920.

The HSE and Government accepts the need to both increase and modernise pay arrangements for our staff working in the National Ambulance Service (NAS) but is also obliged to ensure that in exchange for significant increases in pay, our services can continue to transform to meet the needs of the public. 

These reforms are important because they will deliver better care for patients in the right place - in some cases avoiding the need to go to hospital - faster response times, more ambulances on the road, better deployment of staff to safely treat more people, with the right training and ongoing professional development to support them.

The HSE remains firmly committed to addressing the current dispute through the process set out in Public Service Agreement 2024 – 2026 and calls upon both SIPTU and Unite to withdraw the proposed industrial and strike action and engage through the State’s industrial relations mechanisms.