Ian has worked for the ambulance service for 20 years. Like most paramedics, he turns up early to check his vehicle and equipment, and almost every workday overruns, sometimes by as much as two hours. “It is hard, there’s no doubt about it, and getting harder all the time,” he says. “There aren’t enough paramedics and, as the NHS becomes more broken up, more fragmented, we are left to pick up the pieces. When there’s nobody else to turn to, we get the call, even if we’re not the people who should be dealing with an incident.” During a recent health crisis in UK hospitals, the pressure on ambulance staff, supplemented by support from the Red Cross, St John Ambulance and firefighters, has been huge. Crews have worked extra shifts and longer hours. He has driven patients into hospital with the knowledge that there are no beds available, but also says, “We end up doing the job community nurses or social services really should be doing – making sandwiches, brewing cups of tea for people who have nobody else.”