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.

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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.

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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.”

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.

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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.

Unions were meeting the health secretary this afternoon ahead of Wednesday’s ambulance worker strikes but union heads did not expect a pay offer to be made.

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Rachel Harrison, GMB national secretary, said: “We’ve been given half an hour to meet with the secretary of state to discuss an emergency cover for tomorrow, which considering our strike starts at midnight, is a bit late in the day.

“But those agreements have already been reached at local level. So unless the secretary of state is willing to talk to us about pay today, those strikes are set to go ahead.”

Earlier, Mr Quince told Sky News the meeting would be about which cases ambulance workers would have to go to during the strike – and not pay.

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