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Dear Member

Our second attempt at getting a mandate for industrial action in West Midlands Ambulance Service NHS Trust is underway. 

Tomorrow, Friday 16 December, we will send notice of intention to ballot to your employer, formally beginning the ballot process. 

And next week, the first round of strike action will take place in a number of NHS employers around the country.

  • This week – we hand in ballot notices to your employer 
  • Next week - First round of action in other employers takes place 
  • Over Christmas – we prepare ballot lists ready for dispatch 
  • From 6 January – ballots are posted 

In November we almost hit the majority turnout needed for industrial action in West Midlands Ambulance Service NHS Trust – it was very close and we think postal delays contributed to missing the target. We think West Midlands Ambulance Service NHS Trust stands a good chance of meeting the target if we go again – this time allowing longer for post to get through. 

It's frustrating, I appreciate, to do this all over again. But the result was close enough that we think there is a real majority of support for industrial action among UNISON members in your employer and that, had there not been postal delays, that majority would have been reflected in the result. We want to give you every opportunity to meet the threshold and join the thousands of UNISON members in the NHS already planning strike action. 

We really want this to work. We know you will be keen to get going but we want to avoid as many problems as possible. That means we will not send ballot papers until 6 January. We want to avoid adding to the significant strain faced by postal workers over Christmas, whilst also giving members a couple of final weeks to make sure their postal address and mobile phone number is up to date. 

Whether or not you voted in the previous ballot over pay, you must return your vote this time. 

Ballot details 
The ballot opens on 6 January and closes on 16 February so you need to ensure that you get your ballot paper in the post in good time. Your vote must be received by the deadline to count so look out for your blue envelope and post your ballot paper back as quickly as possible.

We need your help in getting all our members to vote too. As we know from last time, unless 50% of your colleagues VOTE YES for the NHS you will not be able to take industrial action. This is because of the law on ballot thresholds. 

Without a high turnout we run the risk of members not being allowed to take the action they voted for. NHS staff lose and the Government wins. We can’t let that happen. 

Because a miserly award of just 72 pence an hour is not enough to help staff, not enough to prevent staff leaving, and not enough to attract new recruits. It worsens the staffing crisis that is so damaging for patients and staff. 

Kind regards,
Sara Gorton
UNISON head of health

All UNISON members employed in the NHS were all recently balloted for industrial action in a dispute over pay, following the below inflation pay award.

At the West Midlands Ambulance Service, there was a huge strength of feeling from members, with 88.7% of the members who voted voting in favour of strike action. The turnout was higher than at any other West Midlands NHS employer.

However, in order to take legal industrial, the turnout has to be over 50%.

49.6% members employed by West Midlands Ambulance Service voted in the ballot - just a handful of members short.

What: A re-ballot will take place

A decision by UNISON’s Health Service Group Executive has been made to re-ballot West Midlands Ambulance Service members. Other Ambulance Services were also very close to the 50% threshold and will be re-balloted: Welsh, South Central, East of England, East Midlands and South East Coast Ambulance Services, in addition to some Hospital Trusts which were also close to threshold.


When: 6 January – 16 February 2023

One issue that had an impact on the ballot results was the postal strikes and delays. Members have let us know that they did not receive a ballot on time. Therefore, due to the six days of CWU postal strikes and three bank holidays over the Christmas period, the re-ballot will start early January to try and avoid delays as much as is possible and will run for two weeks longer than the first. We appreciate many members would like to re-ballot sooner but we are keen to not face more ballot delays and postal issues over the Christmas period.


How: A postal ballot – please return yours when you receive it.

It will be another postal ballot. It has to be by law. The law is created to try and make industrial action as difficult to take as possible. Elections of the leaders of the major political parties can take place online – but trade union industrial action ballots have to be done by post. MPs can be elected on any turnout. But for strike action to take place a minimum of 50% turnout.

What can you do now?

Check your membership details are up to date. Many ballots were sent to previous home addresses first time around, and the postal delays meant some members who updated their address during the ballot period did not receive a paper in time. Please update your details online here now: My UNISON | UNISON National

Let us know if you are retiring or going on maternity leave between March – September 2023. You may be exempt from the ballot. Please email This email address is being protected from spambots. You need JavaScript enabled to view it. if you may not be in work between March – September 2023.


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