On the day that ambulance workers went on strike for the first time in a generation, the number of 999 calls being made appears to be plummeting in some areas across the country.

Hours into the strikes by 10 of 11 ambulance trusts in England and Wales, Health Service Journal reported a fall in the volume of 999 calls across the country.

The journal said West Midlands Ambulance Service had seen a 70 per cent drop in its calls, raising fears that the seriously ill are not making contact.

As paramedics and ambulance crews took to picket lines across England and Wales, senior medics raised concern that those in need of emergency care may not be coming forward.

Christina McAnea, the general secretary of Unison, said it was "absolutely the Government's" fault and accused them of being "totally irresponsible".

You should only call 999 if you think you are going to die, an ambulance chief said as tens of thousands of staff walked out.

Stephen Segasby, chief operating officer of North East Ambulance Service, wants patients to ask themselves: “Am I going to die? Do I feel like I am going to die?” As a war of words escalated on Wednesday morning between union chiefs and ministers, on the ground Mr Segasby told patients: “Ambulances will still be able to respond during the strike, but this will only be where there is an immediate risk to life.”

No trains until second week of January

In other strike-related news, some commuters may not be able to return to the office until mid-January due to more industrial action on the railways.

Passengers were greeted with a sign telling them that there will be no Chiltern Railways services between Amersham and London Marylebone until Jan 8 on Wednesday morning.

It is thought that hundreds of stations - predominantly on branch lines - will be cut off until the second week of January.