A report, launched at Unison's annual conference in Liverpool, shows that 27% of control room staff quit their jobs over the past three years.

The research shows that 510,254 days were lost to sickness in 999 control rooms across the UK from April 2021 to March 2024. The figure for 2023/24 alone was 166,940, the equivalent of more than a month of sick leave for each 999 call handler, this compares with just four days on average for UK workers.

Unison says high staff turnover and increased sickness absences mean people are having to wait longer for 999 staff to answer calls or for their emergency to be properly assessed and dealt with.

Last year, South East Coast Ambulance Service had the highest staff turnover (80%) followed by North East (33%), Yorkshire (31%), and South Central (28%).

South East Coast had the highest average number of sick days per person in 2023/24. Figures provided by the trust show 19,319 were recorded that year, the equivalent of more than 54 days per call handler.

Unison is calling for better training, regular breaks during shifts and improved emotional support. Call handlers should also be regraded, says the union, from band 3 to a band 4 on the NHS pay scale. That would mean a starting salary of £26,530 a year, which would give staff more of a financial incentive to stay and better reflect the work they do, says the union.

Christina McAnea, Unison general secretary, said: 'TV programmes about ambulance services don't show things as they really are. Call handlers are under immense pressure, making split-second decisions that directly affect lives. They handle relentless calls, often from people in distress, while dealing with complex emergencies and with limited resources. Despite their crucial role, 999 call handlers frequently face emotional strain and operate in an environment where support is sometimes lacking.

'The job is rewarding, but the challenges behind the scenes are far greater than most people realise. It's bad for morale and for patients when so many staff quit or are burnt out. Callers who dial 999 need to know the person picking up the phone is ready to deal with their crisis.

'Ambulance employers must do more to protect the health and wellbeing of staff who provide such high stakes support. This would help create a more stable emergency service that can retain the skills and experience of emergency call handlers, and persuade people to stay in the job for longer.'

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Anna Parry, managing director of The Association of Ambulance Chief Executives, said: ‘These pressures are never underestimated by ambulance service leaders, who respect the commitment and dedication of their colleagues working in 999 control centres. All ambulance services have a full range of wellbeing support in place for colleagues in their 999 control centres in recognition of the potentially stressful and traumatic nature of the situations they are exposed to over the telephone. While this varies in each trust, there is a national emphasis on sharing of ‘best practice', for example Mental Health First Aid training for leaders of teams, down-time between calls, comprehensive debriefing, providing feedback to call staff on patient outcomes, best practice training for leaders and more.

'Additionally, much work has been done nationally to address the growing issue of verbal abuse aimed at 999 ambulance call handlers with a series of positive actions taken to tackle this.

'Despite these initiatives however - as the Unison report rightly highlights - the challenging nature of the call handling role can sometimes lead people to leave the service, which is always a regrettable outcome. However, it is also important to note that the call handling role is often used as an entry level role into the wider ambulance service and, consequently, we do see a significant number of people developing into leadership roles, or as emergency care assistants and even paramedics, which boosts the overall number of qualified ambulance people considerably.

'The ambulance sector will continue to work together to prioritise wellbeing and support for call handlers across all of its 999 control centres.'

A spokeperson for South East Coast Ambulance Service, said: ‘We are committed to reducing staff turnover and we are pleased, following improvements to our recruitment processes, we have reduced the loss of new starters from training by 25%.

'We are also pleased that there is an improving trend on both staff turnover and sickness in recent months. This is despite strong competition for similar employment in our region, particularly close to our West EOC (Emergency Operations Centre) in Crawley. The higher turnover we have seen in recent years should also be seen in the context of a number of colleagues deciding to leave their roles due to the requirement to relocate from our EOC in Coxheath to Gillingham.

‘We recognise the importance of colleague's health and wellbeing and we have several support mechanisms in place to provide assistance to colleagues including our Trauma Risk Management (TRiM) support programme, chaplaincy, and Wellbeing Hub including wellbeing practitioners assigned specifically to our EOCs.'

A spokesperson for Yorkshire Ambulance Service NHS Trust said: 'We recognise the challenging nature of the role of 999 call handlers and we have a number of measures in place to support them, including excellent supervisory oversight, opportunities for staff to have down-time after difficult calls, and a dedicated health and wellbeing team.

'In 2025-26, we're seeing improvements in staff retention rates and sickness levels, reducing to 16.58% and 6% respectively in May 2025, and we continue to support our staff to develop their careers at the Trust with progression now offered to band 4 roles.'