Strikes by NHS nurses could start within weeks and last six months, the 106-year-old union has warned after its members voted for industrial action in its ‘historic’ first ever ballot.
More than 300,000 members were asked whether they supported striking over pay and working conditions by the Royal College of Nursing (RCN).
Nurses at more than 100 NHS trusts in England voted in favour, while some ambulance trusts and integrated care boards will also walk-out with chaos expected to reach all corners of the NHS.
RCN members in every service in Scotland and Northern Ireland also backed the strikes, along with all but one health board in Wales.
The union has warned that strikes will kick-off before Christmas and run sporadically until May — spanning around six months.
On strike days, affected hospitals will only offer ‘bank holiday’ service which is expected to hit thousands of patients, causing delays and cancellations for routine treatment from operations to chemotherapy. Emergency care will not be put at risk.
An NHS boss said hospitals will do all they can to ‘minimise harm to patients’ but admitted operations and appointments will be cancelled or postponed.
Ministers have refused to meet the RCN’s pay request, the equivalent of 17 per cent for every nurse, or £6,000 for the average medic earning around £35,000.
No10 argued the demands would effectively cost the taxpayer £9billion — equivalent to six per cent of NHS England’s entire budget — which ‘in the current climate is simply not deliverable’.
New Health Secretary Steve Barclay said it was ‘disappointing’ that nurses had voted to strike.
Tories have labelled the action ‘criminal’ and warned that lives will be lost as a result of the action.
Where WILL strike action take place?
East Midlands Ambulance Service NHS Trust
NHS Derby and Derbyshire ICB (Joined Up Care Derbyshire)
NHS Nottingham and Nottinghamshire ICB
Derbyshire Healthcare NHS Foundation Trust
Northamptonshire Healthcare NHS Foundation Trust
Derbyshire Community Health Services NHS Foundation Trust
Nottinghamshire Healthcare NHS Foundation Trust
Nottingham University Hospitals NHS Trust
Kettering General Hospital NHS Foundation Trust
EAST OF ENGLAND
Cambridgeshire and Peterborough NHS Foundation Trust
Norfolk and Norwich University Hospitals NHS Foundation Trust
Cambridge University Hospital NHS Foundation Trust
Royal Papworth Hospital NHS Foundation Trust
East Suffolk and North Essex NHS Foundation Trust
Norfolk Community Health and Care NHS Trust
Norfolk and Suffolk NHS Foundation Trust
Cambridgeshire Community Services NHS Trust
Hertfordshire Community NHS Trust
West Suffolk NHS Foundation Trust
NHS Hertfordshire and West Essex ICB
NHS Mid and South Essex ICB
NHS Norfolk and Waveney ICB
NHS Suffolk and North East Essex ICB
Imperial College Healthcare NHS Trust
Guys and St Thomas NHS Foundation Trust
Great Ormond Street Hospital for Children NHS Foundation Trust
Hounslow and Richmond Community Healthcare NHS Trust
St George’s University Hospitals NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Royal Marsden NHS Foundation Trust
Tavistock and Portman NHS Foundation Trust
University College London Hospitals NHS Foundation Trust
NHS North Central London ICB
NHS South West London ICB
Mersey Care NHS Foundation Trust
Tameside and Glossop Integrated Care NHS Foundation Trust
Liverpool Heart and Chest Hospital NHS Found Trust
Lancashire Teaching Hospitals NHS Foundation Trust
The Clatterbridge Cancer Centre NHS Found Trust
The Christie NHS Foundation Trust
Wrightington Wigan and Leigh NHS Foundation Trust
Countess of Chester Hospital NHS Foundation Trust
North West Ambulance Service NHS Trust
Liverpool University Hospitals NHS Foundation Trust
Mid Cheshire Hospitals NHS Foundation Trust
Bridgewater Community Healthcare NHS Foundation Trust
Wirral Community Health and Care NHS Foundation Trust
Midlands and Lancashire CSU
Wirral University Teaching Hospital NHS Found Trust
Liverpool Women’s NHS Foundation Trust
Central Cheshire Integrated Care Partnership
St Helens and Knowsley Teaching Hospitals NHS Trust
Alder Hey Children’s NHS Foundation Trust
The Walton Centre NHS Foundation Trust
Health Education England
NHS Cheshire and Merseyside ICB
NHS Lancashire and South Cumbria ICB
Cheshire and Wirral Partnership NHS Foundation Trust
North East Ambulance Service NHS Trust
University Hospitals of Morecambe Bay NHS Foundation Trust
Northumbria Healthcare NHS Foundation Trust
County Durham and Darlington NHS Foundation Trust
Gateshead Health NHS Foundation Trust
The Newcastle Upon Tyne Hospitals NHS Foundation Trust
South Tees Hospitals NHS Foundation Trust
North of England CSU (NECS)
Kent Community Health NHS Foundation Trust
East Sussex Healthcare NHS Trust
University Hospitals Sussex NHS Foundation Trust
South East Coast Ambulance Service
Sussex Community NHS Foundation Trust
Sussex Partnership NHS Foundation Trust
Queen Victoria Hospital NHS Foundation Trust
NHS Kent and Medway ICB
NHS Surrey Heartlands ICB
Southern Health NHS Foundation Trust
Oxford University Hospitals NHS Foundation Trust
Portsmouth Hospitals NHS Trust
University Hospital Southampton NHS Foundation Trust
South Central Ambulance Service NHS Foundation Trust
Solent NHS Trust
Royal Berkshire NHS Foundation Trust
Oxford Health NHS Foundation Trust
Cornwall Partnership NHS Foundation Trust
Devon Partnership NHS Trust
South Western Ambulance Service NHS Found Trust
SOUTH WEST (CONTINUED)
Dorset Healthcare University NHS Foundation Trust
Gloucestershire Hospitals NHS Foundation Trust
North Bristol NHS Trust
Torbay and South Devon NHS Foundation Trust
University Hospitals Plymouth NHS Trust
University Hospitals Bristol and Weston NHS Foundation Trust
Dorset County Hospital NHS Foundation Trust
NHS Blood and Transplant (NHSBT)
Gloucestershire Health and Care NHS Foundation Trust
Royal Devon University Healthcare NHS Foundation Trust
Avon and Wiltshire Mental Health Partnership NHS Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
University Hospitals Dorset NHS Foundation Trust
Somerset NHS Foundation Trust
Royal Cornwall Hospitals NHS Trust
Royal United Hospitals Bath NHS Foundation Trust
NHS Bath, North East Somerset, Swindon and Wiltshire ICB (BSW Together)
NHS Devon ICB (One Devon)
NHS Dorset ICB (Our Dorset)
NHS Gloucestershire ICB (One Gloucestershire)
Midlands Partnership NHS Foundation Trust
Herefordshire and Worcestershire Health and Care NHS Trust
The Royal Orthopaedic Hospital NHS Foundation Trust
Worcestershire Acute Hospitals NHS Trust
Shropshire Community Health NHS Trust
University Hospitals Birmingham NHS Foundation Trust
Birmingham Women’s and Children’s NHS Foundation Trust
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Dudley Integrated Health and Care NHS Trust
NHS Birmingham and Solihull ICB (BSol ICB)
NHS Black Country ICB
YORKSHIRE AND THE HUMBER
Sheffield Health and Social Care NHS Foundation Trust
Barnsley Hospital NHS Foundation Trust
York and Scarborough Teaching Hospitals NHS Foundation Trust
Leeds Community Healthcare NHS Trust
Bradford Teaching Hospitals NHS Foundation Trust
Harrogate and District NHS Foundation Trust
The Leeds Teaching Hospitals NHS Trust
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield Children’s NHS Foundation Trust
NHS West Yorkshire ICB
Cardiff and Vale University Health Board
Powys Teaching Local Health Board
Welsh Ambulance Services NHS Trust Headquarters
Hywel Dda University Health Board
Swansea Bay University Health Board
Cwm Taf Morgannwg University Health Board
Betsi Cadwaladr University Local Health Board
Velindre NHS Trust
Public Health Wales
Health Education and Improvement Wales Health Authority
NHS Wales Shared Services Partnership
Digital Health and Care Wales
NHS Education For Scotland
NHS National Services Scotland
NHS Western Isles
NHS Dumfries and Galloway
NHS Golden Jubilee
The State Hospitals Board for Scotland
NHS Ayrshire and Arran
The Highland Council
Healthcare Improvement Scotland
Public Health Scotland
NHS Greater Glasgow and Clyde
Scottish Ambulance Service
NHS Forth Valley
Northern Ireland Practice and Education Council
Southern Health and Social Care Trust
Western Health and Social Care Trust
Belfast Health and Social Care Trust
Business Services Organisation
Regulation & Quality Improvement Authority
Northern Ireland Blood Transfusion Service
Public Health Agency
Northern Health and Social Care Trust
South Eastern Health and Social Care Trust
Northern Ireland Ambulance Service
Industrial action is expected to begin before Christmas, with reports it will take place over two dates, potentially a Tuesday and a Thursday
This graph shows the Royal College of Nursing’s demands for a 5 per cent above inflation pay rise for the bands covered by its membership which includes healthcare assistants and nurses. Estimates based on NHS Employers data
The RCN is just one NHS union which has or is balloting its members over pay
In England and Scotland, trade unions must meet an additional 40 per cent support threshold among all workers eligible to vote, as well as the 50 per cent turnout threshold. This means that if 100 important public services workers are eligible to vote, at least 50 must turn out and vote, and at least 40 of them must vote in favour.
Given that not all trusts will participate in the strikes, an already deepening postcode lottery of care is expected to worsen, with different areas of the country to suffer vast disparities in waiting times for appointments, treatment and ambulance responses.
Critical care in life threatening situations should not be put at risk if strikes take place, however elective treatment, outpatient care and other healthcare services, including chemotherapy, dialysis and surgery, are likely to be impacted.
In addition to nurses, approximately one million NHS staff members, including junior doctors, midwives, ICT staff and porters, are either being balloted or are expected to be balloted on strike action over anger about pay rises
MPs have warned workers to ‘think very carefully’ over strike action and pay demands that ‘would just break the NHS completely’. Health insiders said if the strikes went ahead, it could see hospitals fall into disrepair and patients’ calls go unanswered.
Health Secretary Steve Barclay (left) has been accused of being the invisible man due to his lack of action on a looming NHS nurses strikes. Breaking his silence today, he said: ‘We are all hugely grateful for the hard work and dedication of NHS staff, including nurses, and deeply regret that some union members have voted for industrial action’. Pat Cullen (right), RCN General Secretary, presented the ‘historic’ results of the union’s strike ballot to members earlier today, before it was announced
Education Secretary Gillian Keegan this morning suggested most nurses forced to use foodbanks are being driven to do so by a broken ‘relationship or boiler’ on Sky News. The former Minister for Care and Mental Health has previously been criticised for sporting a £10,000 Rolex watch
Matthew Taylor, chief executive of the NHS Confederation, which represents most NHS organisations, told BBC Breakfast there are national and regional plans to minimise the impact on patients, but admitted operations and appointments will have to be cancelled or postponed
Fury as Rolex-wearing minister says nurses ‘usually’ only use foodbanks when they’ve been dumped or their boiler has broken
Pictured: The £10,000 Rolex Lady-Datejust 31 Everose Education Secretary Gillian Keegan was thought to be wearing while claiming nurses ‘usually’ only use foodbanks if they have been dumped or their boiler
A Government minster’s claim that nurses ‘usually’ only use foodbanks if they have been dumped or their boiler has broken sparked fury today.
Unions said Education Secretary Gillian Keegan’s comments, made while wearing a £10,000 Rolex, showed a ‘staggering lack of empathy’.
It comes after the Royal College of Nursing confirmed that tens of thousands of nurses will strike this winter after a ‘historic’ ballot. Cancer treatments and routine operations could be axed.
The union is arguing for an inflation-busting pay rise for its NHS nurses amid reports staff are being forced to use food banks due to the rising cost of living.
Ms Keegan told Sky News: ‘Quite often when you go to food banks, something will have happened, you know, something will have broken down – either a relationship or boiler or anything.
‘Usually they’re in an emergency situation.’
Ms Keegan, who also claimed she didn’t think there was ‘any point’ in nurses striking, said she had ‘of course’ clapped for nurses during the pandemic.
Unions representing NHS staff reacted furiously to the comments.
Rachel Harrison, GMB National Secretary, said: ‘Does Ms Keegan think we have 135,000 vacancies in the NHS because of break ups? Or is it the systematic underpayment of health professionals.
‘Nurses and other NHS workers have been forced to use food banks because they are desperate after more than a decade of real terms pay cuts under the Conservatives.
‘To suggest they do it because of a relationship bust up shows a staggering lack of empathy.’
GMB is currently balloting almost 20,000 workers across the NHS, including nurses.
Matthew Taylor, chief executive of the NHS Confederation, which represents most health service organisations, told BBC Breakfast today there are national and regional plans to minimise the impact on patients.
But he admitted operations and appointments will have to be cancelled or postponed.
He said: ‘Clearly industrial action is a challenge for the health service and NHS leaders.
‘We’re already coping with the gap that exists between the demand that is currently on the health service from the public. We’ve got to meet that demand, and we all know that we are heading into what already is a very difficult winter.
‘Then we add industrial action into that and it’s going to be an extremely difficult job.
‘The priority will be to try to minimise patient harm.’
He noted that the RCN has promised to maintain emergency and critical care ‘but there will be an impact if there is industrial action in terms of cancelled appointments, cancelled procedures, and NHS leaders will do everything we can to minimise that and to ensure that patients are kept informed of what is happening.’
He said workers take industrial action as a last resort — and that the action is about pay, workload and ‘the fact that there are nearly 50,000 nurse vacancies across the NHS’.
Mr Taylor said: ‘Even if there wasn’t any industrial action, we would still have a really big issue about how we recruit, how we retain and how we motivate staff in the NHS.’
The health leader said workers have been ‘waiting for a very long time’ for a properly-costed workforce strategy from the Government.
There have also been ‘briefings in recent days that there will be a pay freeze or pay cap on the public sector next year — that kind of background is not helpful to these talks.’
Patricia Marquis, RCN director for England, told BBC Breakfast that current NHS services were ‘not safe’ and the Government has ‘failed to listen’ to nursing staff.
She said most employers need 14 days’ notice of strike action, adding: ‘What I can say is that we intend to take action certainly before the end of this year.’
Saffron Cordery, interim chief executive of NHS Providers, urged ministers to talk to the unions to reach a resolution. ‘We have to see the Government come round the table,’ she said.
A senior health insider told the Daily Mail that lives will be lost due to the strikes, emphasising that ‘nurses are going to withdraw for non-urgent care but crucial care’.
They said: ‘Everything from routine blood tests, mammograms, smear tests, colonoscopies, skin biopsies, X-rays will come to a halt if routine treatment is cancelled. They’re all considered as non-emergency but everything is crucial when it comes to healthcare, including preventative action.
‘Many of these are often investigations for more sinister symptoms and conditions such as cancer. Instead of getting care, patients will see if their symptoms have gone away and turn to complementary treatment, such as taking pain killers, or a massage, or getting acupuncture, going to see an osteopath when really they need an MRI scan.
‘The impact of coordinated strikes will be that death rates will rise.
‘There will be a knock-on-effect, with a lag on the damage that will be done. The strikes are intended to impede the system but anything that impedes the system will impede patients too.’
And while some staff might be brought in to help with routine treatment, they emphasised that nurses are irreplaceable: ‘Non-qualified staff are not trained for problems such as spotting when a temperature is rising, or when a patient is dehydrated, or when someone needs screening for sepsis. They did it in the pandemic and it was a disaster.’
Pharmacists are also concerned about the knock-on-effect in their sector.
Malcolm Harrison, the Chief executive of the Company Chemists’ Association (CCA), the trade association for large pharmacy operators, said: ‘A nursing strike will inevitably force patients to seek the urgent care they need outside of hospitals. As they did during the pandemic, when they find that their GP cannot help them, many people will once again turn to their local pharmacy.
‘Community pharmacies will be there for the NHS and for patients, for now. However, after years of underfunding and the huge cost pressure of a workforce crisis brought about by poorly planned NHS recruitment, the pharmacy network is on the brink of collapse.
Dr Martin Scurr, a GP with more than 20 years experience, said: ‘It’s the nurses and the doctors who signed up to put the patients first. To go against that tide, just because you want a pay cheque, it’s not right.
‘I know people have things they need to pay for, childcare and paying off loan medicines, but we need to do it honourably. But the pendulum swings, I never thought I’d be able to get a mortgage when I graduated, but it did happen in the end. We can’t do everything now.’
Mark Jenkinson MP told the Daily Mail this week: ‘In the same way as the police can’t walk out, I think those who choose the caring professionals need to think very, very carefully about the impact on the wider NHS.
‘Creating larger backlogs gives us greater pressure on budgets, which then impacts the ability for future pay rises. I mean, the NHS is on track to take nearly half of our national budget.
‘I fully understand the pressures of nurses but I heard a nurse this morning saying that nothing below five percent above inflation will do, but that would just break the NHS completely.
‘I think we’ve just got to be really careful about the impact on the NHS on patients and that’s why we have an independent pay review body to make these decisions, independent of government, independent of the unions, quite deliberately.’
The PM’s official spokesman said: ‘We hugely value the hard work and dedication of our nurses. It is deeply regrettable that some union members are considering this action.
‘These are challenging times for everyone and obviously including the nurses. You’ll know the RCN is asking for a 17 per cent pay rise. To deliver that for all staff on Agenda for Change contracts – that would be nurses essentially all staff minus doctors dentists – that would cost £9 billion. In the current climate that is simply not deliverable.
‘We do want to give nurses a fair pay award that strikes the balance between the crucial role they play and managing the significant fiscal challenges we face. That is why we have given one million NHS workers pay rises of at least £1,400 this year.’
It comes as a nurse revealed that she is forced to eat patients’ leftovers while she is working because she cannot afford food in the hospital canteen or the groceries to make a packed lunch.
Esther, who did not share her last name or the hospital she works at, told The Mirror that it is not allowed and she has been reprimanded when caught – but continues to do so to avoid feeling lightheaded during her shift.
And the 36-year-old, who moved to the UK from Zimbabwe last September, said lots of her colleagues do the same. She voted in favour of strike action.
The mother-of-three said: ‘Yes, I go without meals. Lunch, sometimes breakfast. You can’t go and buy a hot meal at work, it costs £6-7.
‘Sometimes you have to grab extra sandwiches from the patients’ trollies. Of course people will tell you it’s against hospital policy. Some say it’s okay. Most of the time I do that.
‘Sometimes they reprimand you, but they have not reported me. It is common to take the leftover food, even the British nurses do this. ‘It’s only ever the leftovers, and it keeps you going.’
Nursing staff were balloted following NHS Agenda for Change pay announcements earlier this year, which left experienced nurses 20 per cent worse off in real-terms compared to ten years earlier, the RCN said.
The Fair Pay for Nursing campaign is calling for a pay rise of five per cent above inflation (measured by RPI).
RCN General Secretary and Chief Executive Pat Cullen said: ‘Anger has become action – our members are saying enough is enough. The voice of nursing in the UK is strong and I will make sure it is heard. Our members will no longer tolerate a financial knife-edge at home and a raw deal at work.
The NHS waiting list for routine operations in August in England breached 7million for the first time ever. This includes almost 390,000 patients who’ve been forced to wait over a year for treatment
The latest NHS data recorded that about 45,000 nursing posts in England are vacant as of the end of June. London has highest percentage missing, with 15 per cent of nursing posts unfilled
NHS data shows efforts to get more nurses into the health service are only barely keeping pace with the number of experienced nurses quitting
Doctors warn that failing NHS IT systems are ‘undermining’ patient safety
‘Failing’ IT systems in the NHS are a threat to patient safety. medics have warned.
Doctors and nurses should not ‘tolerate problems with IT infrastructure as the norm’, according to a new editorial, published in The BMJ.
Experts from Imperial College London and University College London point to an incident in which IT systems at Guy’s and St Thomas’ NHS Foundation Trust – one of the largest hospital trusts in the country – went down for 10 days.
The outage, caused by the July heatwave, led to procedures and appointments being postponed for a number of patients.
The new editorial highlights how IT failures can restrict services as doctors are unable to access records and are prevented from ordering diagnostic tests.
This can ‘bring a halt to the everyday business of healthcare’, they said.
A recent analysis from the British Medical Association concluded that 27% of NHS clinicians lose more than four hours a week through inefficient IT systems.
The authors of the latest article suggest that the NHS IT infrastructure is ‘crumbling’ and leads to ‘poor user experiences’ as well as patient safety incidents.
‘Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care – they result in patient harm and increased costs,’ they wrote.
The authors suggest that investment in IT systems is frequently overlooked as the NHS tries to keep costs down.
‘There is a growing disconnect between Government messaging promoting a digital future for healthcare (including artificial intelligence) and the lived experience of clinical staff coping daily with ongoing IT problems,’ the authors added.
They called for the Government to provide investment for IT systems in the health service, but in exchange ministers should ‘demand accountability, with minimum standards for IT function and stability’,
Meanwhile they suggested that the health watchdog – the Care Quality Commission – should examine IT failures as part of its inspection regime.
They conclude: ‘We must not tolerate problems with IT infrastructure as normal.
‘Poorly functioning IT systems are a clear and present threat to patient safety that also limit the potential for future transformative investment in healthcare. Urgent improvement is an NHS priority.’
‘Ministers must look in the mirror and ask how long they will put nursing staff through this. While we plan our strike action, next week’s Budget is the UK government’s opportunity to signal a new direction with serious investment. Across the country, politicians have the power to stop this now and at any point.
‘This action will be as much for patients as it is for nurses. Standards are falling too low and we have strong public backing for our campaign to raise them. This winter, we are asking the public to show nursing staff you are with us.’
Health and Social Care Secretary Steve Barclay said: ‘We are all hugely grateful for the hard work and dedication of NHS staff, including nurses, and deeply regret that some union members have voted for industrial action.
‘These are challenging times, which is why we accepted the recommendations of the independent NHS Pay Review Body in full and have given over one million NHS workers a pay rise of at least £1,400 this year. This is on top of a 3 per cent pay increase last year when public sector pay was frozen and wider government support with the cost of living.
‘Our priority is keeping patients safe during any strikes. The NHS has tried and tested plans in place to minimise disruption and ensure emergency services continue to operate.’
An NHS spokesman said: ‘While pay is a matter for Government and the trade unions, we value our staff and want to see a resolution as soon as possible to ensure we can continue to focus on supporting our NHS organisations to deliver world class patient care to all those who need it.’
Saffron Cordery, interim chief executive of NHS Providers, said: ‘Trust leaders have been planning for possible strikes. Their priorities are to ensure the safe delivery of care and services for patients during any industrial action and to support the wellbeing of their staff.
‘We need to see the detail of what any action might look like but trust leaders will do all they can to minimise disruption for patients.
‘We understand just how strongly nurses feel and why they’ve got to this point: below-inflation pay awards amid the rising cost of living, severe staff shortages and ever-increasing workloads. The context of a very challenging period due to the COVID-19 pandemic also can’t be understated.
‘The government needs to sit down with union leaders to find an agreed solution as soon as possible. Prolonged action is something everyone wants to avoid.’
The British Medical Association, which represents 160,000 doctors and medical students, is balloting junior doctors from January 9.
Dr Emma Runswick, deputy chair of doctors’ union BMA council, said: ‘Doctors offer our support and solidarity to nursing colleagues following this historic ballot for industrial action. Like us, nurses are showing that they have had enough of being undervalued by this Government.
‘Along with other frontline healthcare workers, nurses have borne the brunt of an understaffed and under-resourced health service, where despite their best efforts and working at their absolute limits, healthcare staff are too often unable to provide patients with the care they need. This Government has responded by repeatedly cutting their pay in real terms and causing genuine hardship for many.
‘It is still within the Government’s gift to pay healthcare staff fairly for the vital, often lifesaving work that they do. We urge Government to listen to the concerns of frontline health staff and deliver the investment that the NHS and its workforce so desperately need.’
Wes Streeting MP, Labour’s Shadow Health Secretary, said: ‘There were no strikes in the NHS during 13 years when Labour was last in government. If we were in office today, we would be talking with the RCN and doing everything we can to prevent these strikes going ahead.
‘Government ministers spent the summer dodging calls and requests for meetings from the Royal College of Nursing. It is unacceptable negligence.
‘The Conservatives have stopped governing and it is nurses and patients who will be made to pay the price.’
Nurse strike Q&A: How much cash do they want? When will walk-outs happen? And how will patients be affected? All the big questions answered as Royal College of Nursing confirms ‘historic’ action
NHS nurses will walk off the job this winter, the Royal College of Nursing (RCN) has confirmed, as the union released the results of its historic strike action ballot.
The result means tens of thousands of NHS nurses, healthcare assistants and midwives will strike this winter over pay.
There are fears that the resulting drop in staffing levels will lead to thousands of diagnostic tests and elective operations being cancelled at a time of record care backlogs.
Strike action could also pile even more pressure on to the health service at its hardest time of year, as it battles winter pressures and expected waves of Covid and flu, triggering concerns admissions will rise and more staff will be off from work.
The RCN is arguing for an inflation-busting pay rise for its NHS nurses amid reports staff are being forced to use food banks or quitting the profession entirely due to the rising cost of living.
Here, MailOnline answers all of your key questions surrounding the strikes and what happens next.
What is the Royal College of Nursing?
The RCN is Britain’s largest nursing unio. Its membership consists of both nurses of all specialties — from the general nurses working in NHS hospitals to specialists like mental health, cancer and paediatric nurses.
Its members also include some other health and care staff groups like midwives and healthcare assistants.
Why are members striking?
The RCN argues that its members working in the NHS are not paid enough and this contributing to staffing problems in the health service.
While this argument has been made for years, soaring inflation has exacerbated these concerns.
There have been reports of nurses struggling to pay their bills or leaving the profession for jobs in sectors like retail.
On October 6, the union launched a historic ballot asking 300,000 members working in the NHS across the UK if they would on taking strike action.
Ballots closed on November 2 and the results were revealed today.
What was the result?
In total, 178 NHS organisations are due to take strike action across the UK after meeting the legal thresholds for strike action.
This includes all of the NHS employers in Northern Ireland and Scotland and all bar one in Wales. In England, this includes 130 NHS organisations.
The types of NHS bodies impacted by strike action includes NHS trusts and health boards which manage hospitals, ambulance trusts, and Integrated Care Bodies which broadly manage NHS services in areas of England.
Of the total organisations that returned a valid strike ballot in England 50 of them are acute NHS trusts that provide hospital care and six out of 11 ambulance trusts.
What does the RCN want?
The union wants nurses to get a pay rise 5 per cent above inflation, which currently sits around 12 per cent.
This would grant the average nurse, who earns roughly £35,600 each year, an extra £6,000 annually.
This is far above the Government’s offer of about 4 per cent.
So what happens now?
The RCN is expected to unveil further details of the strike action in the weeks to come.
This will include which parts of the NHS will be affected by strike action on what days, as well as for how long.
Previous strike action by nurses in Northern Ireland in 2019/20 saw nurses walk off the jobs from almost all services minus those providing life saving care in 12-hour blocks.
I have an operation scheduled at my local NHS hospital in the next few months, could it be cancelled?
Possibly. Previous strikes by NHS staff have led to the cancellation on non-emergency procedures and appointments.
If your appointment is scheduled it could be canceled by strike action as it is probably not classified as emergency or urgent care.
If an individual appointment is cancelled or not will depend if the date falls on a strike action day and is one of those where nurses are walking off the job.
Another factor is how long the dispute between the Government and the union runs.
Some appointments not on strike days may also be delayed as more urgent procedures were cancelled need to be prioritised.
What determines which hospitals or NHS services will strike?
The RCN balloted nurses at 300 NHS hospitals and trusts and 178 came back with a valid result in favour of strike action.
What makes a valid strike action ballot differs depending on the trade union law across the UK nation.
In England and Scotland, 50 per cent of the eligible membership must vote for the ballot to be valid, and at least 40 per cent of votes must be in favour of the action for the result to count.
For Wales, at least 50 per cent of the eligible membership must vote but only a simple majority is needed to determine the result.
Northern Ireland has the least restrictions on strike action ballots, only a simple majority of those who vote is required with no minimum turnout threshold.
When could nurses go on strike?
Northern Ireland requires strike action to take place within one month of the ballot closing, so before December 3.
The law in England, Scotland and Wales states strike action has to be held within six months of the ballot closing, so by the start of May.
Have any dates been announced so far?
No. It is also unclear if the strike will be held continuously, as in for multiple days in a row, or on certain days spaced throughout the month.
Won’t a strike put patients in danger?
Unlike other staff groups who take strike action, nurses are required by law to maintain a minimum staffing level to keep patients safe.
Therefore, some nurses will be exempt from the strike to provide this minimum level of service.
The exact numbers remaining on the job will be negotiated locally between the RCN and each NHS Trust/Board.
What kind of NHS services could be scrapped?
Senior health officials have warned patients are expected to only receive a ‘bank holiday’ level of service on days nurses walk off the job.
This means vital cancer and kidney disease treatments and routine operations like knee or hip replacements could be axed, or rescheduled.
Other procedures and treatment that might be scrapped include chemotherapy and dialysis.
Emergency care is not expected to be impacted by strike action, as this is needed to ensure life-saving care is provided to the public.
Won’t some patients suffer from elective procedure being cancelled?
Yes. Patients on waiting lists for elective care often have a reduced quality of life as they live in pain for months at a time and can suffer health problems from a lack of treatment.
However, the RCN argues that improved pay is needed to help boost staffing in the NHS which is considered to be one of the main reasons contributing to long elective care waiting times in the first place.
If some nurses are still working what’s the point of a strike?
While life-saving care will be provided, a nursing strike is likely to lead to cancellation of hundreds of routine operations.
Similar large-scale strike action by junior doctors in 2016 led to the cancellation of 100,000 patient appointments.
Can nurses be sacked for striking?
No. NHS workers cannot legally be sacked if they participate in official and lawful industrial action.
The nurses regulator the Nursing and Midwifery Council, which has the power to strike off nurses from the profession, has also made it clear it will not penalise nurses for taking industrial action.
Are the strikes avoidable?
The RCN says the Government can stop the strikes if it agrees to meet their demands on pay.
However, the Government has refused to even say it will meet with the union following the result of the ballot.
What is the NHS doing to prepare for strike action?
At the start of November hospitals in England were ordered to plan a military-style operation to prepare for potential strike action.
Called Exercise Arctic Willow, the multi-day operation is designed to test their ‘preparedness’ for winter and will take place in mid-November.
This is an extension to the normal routine winter preparedness exercises carried out by trusts to prepare for seasonal problems like an increase in flu admissions.
Will the Government cave to RCN demands?
Unknown. But if the No10 gives in to nurses it will face pressure to provide similar pay rises to other NHS staff groups, with junior doctors, midwives and other health service staff also arguing for inflation busting pay rises.
At a time when state services are being asked to tighten their belts due to financial pressures the Government is likely to argue it can’t afford to pay NHS staff more than it has offered.
What are other staff groups doing? Is more industrial action on the way?
Nurses aren’t alone in their discontent with NHS pay.
A plethora of other staff groups are mulling over industrial action including potential strikes.
This week the union Unite announced its was expanding its NHS strike ballot to 100,000 members working in the health service in England and Wales.
The new ballot will incorporate nurses, as well as mental health staff, NHS dentists, paramedics as well as health service estate and admin staff.
Unite was previously balloting ambulance drivers in Scotland and England on potential strike action but said the situation in the NHS had prompted an expansion to other groups.
If the Unite ballot returns a yes result, the union said its members would strike in the New Year.
Other previously staff unions that have touted industrial action include the Royal College of Midwives which has asked its 50,000 members to vote in support of action when ballots open on November 11.
Two-thirds have already said they would be willing to strike in a preliminary poll.
More than 15,000 ambulance workers at 11 trusts in England and Wales are being balloted on industrial action over pay and ‘unsafe’ working conditions.
The GMB union said if the strikes went ahead, which could take place ahead of Christmas, it would be the biggest for three decades.
Some 8,000 members in Scotland last week voted ‘overwhelmingly’ in favour of industrial action.
And the Chartered Society of Physiotherapy said more than eight in 10 of its 60,000 members across the UK are prepared to strike.
Members in Scotland last week voted in favour of strike action. Voting in England closes today, while members in Wales have until December 12 to post their ballot.
It makes the first time members have been balloted over pay in the CSP’s 100-year history.
Meanwhile, the British Medical Association will ballot junior doctors in early January on whether it should strike over pay.
A strike goes against what it means to be a nurse. I beg my colleagues to think again, writes NHS staff nurse CARMELAH JACOBS
Six months ago I received the late-night phone call that many of us dread.
My 75-year-old mum had suffered a sudden cardiac arrest and had been taken to a London hospital, where doctors were battling to save her life.
My husband and I live more than 200 miles away in the north of England and, by the time we had made the frantic three-and-a-half-hour drive to her bedside in the small hours, it was too late. My beloved mum had already passed away.
I was devastated, yes. But I will never forget the kindness of the nurses who greeted me in my distress.
These were the men and women who had patiently sat by my mother’s bedside in her final moments – and allowed me in turn to stay with her for hours saying goodbye. ‘Take as long as you need,’ one told me.
Industrial action is expected to begin before Christmas, with reports it will take place over two dates, potentially a Tuesday and a Thursday
That compassion is a quality that, as a nurse myself, I value above almost everything else in my profession.
And while I have remembered my mum every day since, in recent days her final hours have been particularly on my mind.
After all, some of those same nurses who cared for her may now have voted to strike – for the first time in the Royal College of Nursing’s (RCN) 106-year history.
If such a strike action had unfolded on the day she died, my mum’s final hours – and my goodbyes – may have been very different indeed.
That is just one reason I feel enormously saddened by my peers’ decision to strike. There is no question that this action will have devastating consequences for countless patients and their families.
While the RCN has insisted that emergency care will remain unaffected, thousands of operations, chemotherapy and dialysis appointments will be cancelled.
Meanwhile on our wards, I have no doubt that it will mean some patients – people like my mum – may perhaps die alone or be left without the tender touch of a carer.
And that’s why I am urging my colleagues to think again about the action. Should they proceed, it will go against the very tenet of what it means to be a nurse – that the patient always comes first.
Should they proceed, it will go against the very tenet of what it means to be a nurse – that the patient always comes first
That vital principle is recorded in black and white in the Nursing and Midwifery Council code of standards (‘[you must] promote health and prevent ill health’).
Nurses do not, like newly qualified physicians, take the Hippocratic Oath, swearing to uphold a number of professional ethical standards. But what we are there to do unquestionably is to serve our patients. It is instilled into each of us from the moment we put on our uniform, until the moment we retire.
And it is a principle I first absorbed when, 17 years ago, I joined the nursing profession, following in the footsteps of my late mother, Gina, who was a nurse herself for more than 20 years.
My siblings and I were raised on the stories – some sad, some funny – that she told about her patients and the doctors she worked alongside.
She believed passionately, as do I, that nursing was a vocation. She was never interested in working for the money but she was proud of what she did.
It was truly inspiring and I have never once regretted my career choice; not even during the darkest days of the Covid pandemic, when I would return home to my husband and two young children exhausted and traumatised about what had unfolded on my ward.
My mother, who was a nurse herself for more than 20 years, believed passionately, as do I, that nursing was a vocation. She was never interested in working for the money but she was proud of what she did
I believed then – and I believe now – that this is what I signed up for. As nurses, we are trained to be prepared for anything. And while the Covid pandemic created the most extraordinary challenges many of us will ever see in our working lives, we all just had to get on with it.
That’s the job, one you don’t go into for self-advancement, or for money. You do it because you want to give back, and to support and help people through what can be some of the scariest and most important moments in their lives.
In return it can be enormously enriching, inspiring and humbling. Listen to the news and you may hear the occasional horror story – but what you don’t hear about are the countless meaningful connections made day in, day out.
The elderly woman who cries while you hold her hand. The desperately ill young man who breaks out in laughter for the first time in weeks at a joke you made. The former patient who spots you in the street and comes over to thank you for helping them out.
Of course, I understand my colleagues’ concerns and frustrations.
I know that in the busy hospital department where I work in Greater Manchester, morale is low among my fellow nurses.
The Royal College of Nursing confirmed that tens of thousands of nurses will strike this winter after a ‘historic’ ballot. General Secretary Pat Cullen (pictured) called it a ‘once in a generation chance to improve your pay and combat staff shortages’
We’re all working longer hours, covering areas we are not experienced in and frantically trying to make up for staff shortages.
There’s no question Britain is suffering a chronic lack of nurses: when I qualified I used to be responsible for between six to eight patients. Now it’s 12 to 14. Yet while workloads have increased, pay has not kept pace.
To many, the 3 per cent pay rise we were given last year in recognition of work during the pandemic was not enough.
But while I accept that disgruntlement, I also accept that the rough starting salary for nurses of £27,000 – rising to nearly £55,000 for the most senior – is not far off the average salary for many workers across the UK. I also appreciate that many public sector workers have experienced a total pay freeze.
Of course, as the cost of living soars, it is little surprise that many nurses are feeling undervalued.
In fact, I share that sentiment myself. But here’s the thing: I will not be joining my peers and colleagues on the picket line when the time comes. And I never will. Because when you have chosen to work in a caring profession, striking is never the answer.
Whatever grievances we nurses have should be addressed through proper negotiation and discussion, not through walk-outs which, whatever the rhetoric of union bosses, may lead to patient deaths. Even one unnecessary death is one too many.
But I also cannot help thinking of all the other direct consequences left in the wake of striking nurses – less dramatic on paper than death, but still devastating.
I also fear for how strike action will be received among the public – many of whom are hugely grateful for and supportive of NHS workers particularly since the pandemic
I’m talking about the hands not held, the small compassionate gestures not done, or the words of comfort unspoken to grieving relatives – as I myself was just a few months ago.
That is the grim reality of strike action, and it is why I will continue go into work as normal, to visit my ward and look after my patients.
No doubt it will mean working back-to-back shifts to make up for staff shortfalls – all the while knowing that whatever I do will still not be enough – but I and those who join me will do what we can.
Otherwise, I would never be able to forgive myself.
I also fear for how strike action will be received among the public – many of whom are hugely grateful for and supportive of NHS workers particularly since the pandemic.
But goodwill is not limitless, and strikes risk undermining it.
That it is why I am calling – begging – for my nursing colleagues who voted to strike to look into their hearts and think again.