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We follow the team in control and crews out on the road across Greater Manchester as they care for people in the places they call home. Filmed in 2023 in the north west, one of the areas hardest hit by the cost-of-living crisis, the ambulance service increasingly acts as a vital safety net for those struggling to cope. It does this while also working hard to deliver emergency care to over seven million people living in the region, amid some of the darkest times in the NHS’s 75-year history.

It's Wednesday and the start of a new 12-hour shift for the North West Ambulance Service. The team in control are already busy with reports of an unexploded bomb. Multiple resources, including the specialist Hazardous Area Response Team (HART) and the bomb squad are dispatched, with crews told to assemble at a safe point while the scene is assessed. The suspect package is close to a primary school and a nursery, so a 100m cordon is put in place to address safety concerns. The ambulance crews on the ground report back to control that a controlled explosion will be necessary, and they are able to clear from the scene without any casualties.

Meanwhile, queues of ambulances are stacking up at hospitals – Oldham General Infirmary is already experiencing delays, with nine ambulances outside waiting to offload their patients. Chloe and Andy, two dispatchers in control, worry that it will only get worse through the day, as current delays are already causing wait times of over two hours.

A call is made to control regarding an elderly lady who is still on the floor outside the bus station, having been blown over in the wind. The decision is made to upgrade the call to a Category 2 emergency, and Adam and Matt are dispatched. After safely getting their 92-year-old patient off the floor, she is taken to hospital with a suspected broken hip.

Five hours into the shift and reports of another unexploded bomb come into control. In the wake of the Manchester Arena bombing, these threats are taken incredibly seriously, and multiple resources are dispatched including paramedic Hannah, student paramedic Kyle and senior paramedic Matt. The team must wait in a safe place for the bomb squad to leave the first scene and get to them to assess the suspicious package. It is decided to evacuate a school playing field full of children nearby.

As the final hour of the day shift approaches, the North West Ambulance service is feeling the pressure. The current wait time for a Category 1 ambulance is 13 minutes – six minutes longer than the target response time. A call comes in from Fairfield Hospital. A patient has absconded from hospital during a clinical assessment and is at risk of having a heart attack. Andrea and Michelle are immediately dispatched and are met by a patient who used to work with Andrea when she was a nurse. She is struggling to cope with her longstanding health issues but is cheered up by the care of two kind paramedics.

As a new shift begins for the ambulance crews of the north west, senior paramedic Matt is dispatched to a 72-year-old male who is unconscious and not breathing. Sadly, the patient has passed away, but Matt is determined to make his death as dignified as possible and assists by getting him back into bed. Matt then reveals he is also a vicar for the Church of England, and as well as dealing with him physically, he has said a prayer for his patient.

The busy shift continues for Matt, with a call-out to a patient who is unresponsive. After suffering a suspected stroke, Matt helps a crew take her to hospital to get the treatment she needs.

Back in control, call handlers are receiving a new call every 15 seconds, and some patients are waiting over nine hours for an ambulance.

In Bury, Andrea and Michelle are dispatched to an elderly lady who has fallen. Because she can’t remember the details of the fall, they decide to take her to hospital. Discovering the patient lost her husband just two weeks ago, the crew offer nothing but kindness and empathy on the journey to hospital.

Filmed at a time of profound uncertainty across the NHS, this episode highlights the vital role of the ambulance service in saving lives and delivering the very best care despite the immense challenges they face on a day-to-day basis – always putting patients’ physical and emotional welfare at the forefront of what they do. Amidst the constraints of hospital delays and large incidents requiring lots of resources, the crews work tirelessly to deliver the best care they can. This is the real story behind the sirens.