People have been urged to “drink responsibly” by NHS England’s medical director to avoid ending up in A&E as ambulance workers prepare to strike.

Professor Sir Stephen Powis issued the warning ahead of the planned action on Wednesday, when the health service is likely to be hit by major disruption as ambulance workers, including paramedics, control room workers and technicians, walk out in England and Wales.

Health secretary Steve Barclay has said the British public’s “common sense” should be trusted on what is safe during the industrial action.

Nurses launch second day of strikes – live politics updates

But issuing the latest NHS guidance, Sir Stephen said: “There is no doubt that the NHS is facing extreme pressure and industrial action will add to the already record demand we are seeing on urgent and emergency care, and so it is really important that the public play their part by using services wisely.

“People can also help by taking sensible steps to keep themselves and others safe during this period and not ending up in A&E – whether that is drinking responsibly or checking up on a family member of neighbour who may be particularly vulnerable to make sure they are okay.”

Ministers and NHS leaders have said people can still call 999 for emergencies – but should take extra steps to keep themselves and others safe while there is so much pressure on health services.

Asked if people should be more cautious during strikes this week, Mr Barclay said: “We should trust the common sense of the British public.

“They can see that there will be pressures, particularly on ambulances.”

Following a meeting between the health secretary and union bosses on Tuesday afternoon, a Unite spokesman said it was “pointless” as Mr Barclay “refused to discuss pay”.

Onay Kasab, Unite’s national lead officer who was at the meeting, said: “It is disgraceful that the government is failing to take action to avoid NHS strikes, the unions are willing to talk but the government isn’t.

“Barclay was only prepared to talk about derogations, which was futile as these have been thrashed out and agreed down to a fine tooth-comb at a local level.

“His appeal that the agreements on emergency cover are respected was frankly insulting. Our members are taking strike action as an absolute last resort as they witness the NHS crumble on a daily basis. Not only are they committed to covering emergency calls tomorrow, but our members will immediately leave picket lines if a trust for any reason can’t cope with emergencies.”

Nurses with the Royal College of Nursing (RCN) union are striking today and ambulance workers are walking out on Wednesday over a dispute on pay and working conditions.

On Tuesday morning, health minister Will Quince said the public should avoid “risky activity” during the ambulance strike as he urged people to alter their plans to minimise the danger of injuring themselves.

Unions have said ambulance workers will still attend Category 1 (most life-threatening such as cardiac arrest) and Category 2 (serious conditions, such as stroke or chest pain) calls during the strike.

However, ministers said there were still questions over whether ambulance workers at every NHS trust striking were going to do that.

Mr Barclay added: “They’ve said that they will provide life-threatening cover, that they will provide emergency cover.

“It’s essential that they do so to protect patients, because if there’s delays in ambulances, obviously that impacts very seriously on patient safety.

“But of course, the British public will make sensible decisions in terms of their behaviour based on what they can see in terms of the pressures on the health system.”

He added that if it was “extremely icy, you might not go for a run”.

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The prime minister’s spokesman said he was “not going to get into a list” of what “risky activities” people should avoid during the ambulance strike.

By lunchtime on Tuesday, several ambulance and hospital trusts across the country had declared critical incidents due to “sustained” and “unprecedented” pressure on services, including high 999 call volumes and hospital handover delays.

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