No10 is given FINAL chance to avoid devastating nurses strike


The largest NHS strikes in Britain’s history can be avoided if ministers agree to an inflation-busting pay rise, the UK’s nursing union has said, as another NHS union joins the fray. 

The ultimatum from The Royal College of Nursing (RCN) comes as the union is due to publish the results of its ballot on strike action later this week, with a large majority of nurses already understood to have voted in favour. 

More strike pain could also be heading No10’s way, with the union Unite announcing today it will be asking 100,000 of its NHS members if they are willing to walk off the job over pay. 

The RCN ballot marks the first time it has balloted all of its 300,000 members for strike action in its 106-year history. 

An RCN spokesperson said: ‘Once we announce our results, we will be informing the Secretary of State and every NHS employer. 

‘We will be open with our members that ministers have the potential to stop this at any point by doing what is fair by nursing staff.’ 

The union is demanding nurses receive a cost-of-living pay rise of 5 per cent above inflation, which currently sits above 12 per cent. 

This would grant the average nurse, who earns roughly £35,600 each year, an extra £6,000 annually.

The Department of Health and Social Care was contacted on if it would meet with union bosses this week to try and avoid winter strikes but did not respond.

Nurses are just one of the public services profession demanding higher pay than the Government offer.

Meanwhile, 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. 

The union’s national officer for health Colenzo Jarrett-Thorpe said: ‘The strike across the NHS is widening because our members have had enough. 

‘The truth is that they cannot afford to do the job anymore, yet this Government wants to cut their pay further.

‘If our members walk out on strike, it will be the toughest thing they ever do but they have to protect our NHS.’

If the Unite ballot returns a yes result, the union said its members would strike in the New Year.  

No10 has previously refused to budge on its offer of a 4 per cent pay rise for nurses, which union officials say is driving nurses to leave the profession for better paid jobs in retail amid a soaring rise cost-of-living. 

If the Government doesn’t capitulate to the RCN demands, and the unprecedented strikes go ahead, senior health officials have warned patients are expected to only receive a ‘bank holiday’ level of service on days nurses walk off the job. 

The Royal College of Nursing, which balloted more than 300,000 members in the UK, is set to announce that a large majority voted in favour of industrial action. Pictured: NHS staff in London in July 2021 protest against the NHS Pay Review Body's recommendation of a 3 per cent pay rise for NHS staff in England

The Royal College of Nursing, which balloted more than 300,000 members in the UK, is set to announce that a large majority voted in favour of industrial action. Pictured: NHS staff in London in July 2021 protest against the NHS Pay Review Body’s recommendation of a 3 per cent pay rise for NHS staff in England

The walkout, which is expected to take place in December, would come after the first time the 106-year-old union balloted all of its members. Pictured: Staff nurse David Carr addresses NHS staff marching in July 2021

The walkout, which is expected to take place in December, would come after the first time the 106-year-old union balloted all of its members. Pictured: Staff nurse David Carr addresses NHS staff marching in July 2021

Vital cancer and kidney disease treatments and routine operations could be axed as thousands of health workers walk out over pay.

The RCN has also asked agency nursing, who may be drafted in to help shore up staffing numbers to stop the knock-on effects of walk-outs, not to cover positions left vacant by striking staff.

The union’s guidance reads: ‘If you’re an agency worker allocated to work at an NHS organisation on a day of strike action, we expect you do not cover that shift.’

It conflicts with the Government’s efforts to help stop union disruption of essential services.

In July this year, ministers brought in a law allowing for the hire of agency workers to cover industrial action to stop essential services being disrupted.

This was in response to the repeated strike action from transport unions bringing Britain’s rail network to a standstill. 

At the time, then Business Secretary Kwasi Kwarteng said: ‘In light of militant trade union action threatening to bring vital public services to a standstill, we have moved at speed to repeal these burdensome, 1970s-style restrictions.

‘From today, businesses exposed to disruption caused by strike action will be able to tap into skilled, temporary workers to provide the services that allow honest, hardworking people to get on with their lives. 

‘That’s good news for our society and for our economy.’ 

Today the RCN warned any attempts to bring in agency nurses to cover for industrial action would both unsafe and ‘undemocratic’. 

‘Using agency workers to cover strike action is undemocratic and unsafe.’ a spokesperson said.

‘The government is trying to curtail the right of health professionals to be heard.

‘We are strongly encouraging our members who work as agency staff not to cover the shifts.’

Senior health sources said the NHS will operate as if it is Christmas Day on all strike days, with elective treatments scrapped — though emergency care will go ahead.

They also warned the action may exacerbate the bed-blocking crisis, as hospitals often fail to discharge patients who are ready to go home on bank holidays.

Strikes are expected to 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.

And it may worsen the backlog of care that has already piled up, with seven million people in England on the waiting list for elective hospital treatment by August. 

Nurses could end up firing the starting gun of a winter of discontent in the health service, with junior doctors, midwives and paramedics also mulling industrial action.

However, the RCN said nurses have been ‘forced’ into strike action due to a ‘decade of real-terms pay cuts’, warning ‘enough is enough’. 

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 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

A&E waits have also breached a record, with the number of patients facing 12-hour waits exceeding 30,000

A&E waits have also breached a record, with the number of patients facing 12-hour waits exceeding 30,000 

NHS England continued to fail to hit targets to start treatment for the disease within two months of an urgent referral

NHS England continued to fail to hit targets to start treatment for the disease within two months of an urgent referral  

Ambulances took an average of 47 minutes and 59 seconds to respond to category two calls , such as burns, epilepsy and strokes. This is more than twice as long as the 18 minute target

Ambulances took an average of 47 minutes and 59 seconds to respond to category two calls , such as burns, epilepsy and strokes. This is more than twice as long as the 18 minute target

‘Not safe staffing’ and struggling to ‘make ends meet’: Nurses share why they backed strike action 

Unsafe staffing levels and salaries too low to make ends meet has forced nurses to back strikes, one medic has said.

Leanne Lewis, a nurse in Bridgend, Wales, who voted in favour of industrial action, said it was ‘an extremely difficult decision’.

Ms Lewis told BBC Radio Wales Breakfast programme: ‘I felt we needed to take action. Enough is enough.’

She said the NHS is ‘haemorrhaging staff’ and many are not working due to ‘burnout’ and ‘post-pandemic’ complications. Ms Lewis herself is off work and receiving half her pay due to long Covid. 

Leanne Lewis, a nurse in Bridgend, Wales, who voted in favour of industrial action, said it was 'an extremely difficult decision'

Leanne Lewis, a nurse in Bridgend, Wales, who voted in favour of industrial action, said it was ‘an extremely difficult decision’

The situation means there are too few medics working on wards, creating ‘not safe’ staffing levels, she said.

Ms Lewis said: ‘Nurses are absolutely traumatised and fed up of not being able to give the patient care they want to give and that they deserve.

‘It’s heart-breaking to have colleagues phoning me after a shift in tears because they feel they haven’t been able to provide the care they wish they could have due to not having the staff.

‘Staff are leaving the NHS and they’re going back into hospitals working on agency doing exactly the same role for sometimes double, quadruple the amount of wages purely because that’s the only way they can make ends meet.’

Ms Lewis said more needed to be done to encourage more people into the profession.

She said: ‘When I trained I had a small bursary of about £3,500 a year and the actual training was free. Nurses are having to pay now for their training through student loans.

‘They’re paying their day-to-day bills, travel expenses. There needs to some sort of compromise around pay and staffing numbers.

‘The Government needs to sit down with the RCA and other unions and have some serious discussions.’ 

Georgia, a nurse in Newcastle, tweeted that the strikes are a result of ministers failing to take ‘patient safety seriously’.

She said: ‘We don’t want to strike.

‘We want our patients to be safe – with current pay & conditions there aren’t enough nurses to keep patients safe.’

Niamh, an intensive care nurse in Ireland, tweeted her support of strikes.

She said: ‘Tell me again why nurses shouldn’t strike? 

‘Tell me what it’s like to look after 6x ITU patients on a shift by yourself. 

‘Tell me what it’s like to suffer such horrendous PTSD you considered suicide. Enough. Is. Enough.’

A health official told The Daily Telegraph: ‘The understanding we have… is that they will commit to delivering a bank holiday level of service.

‘On bank holidays we don’t do elective work, but we do do emergency work.

‘Outpatient surgery, day surgery, chemo, dialysis… some of the things we have for discharging, transferring care, of patients [which] wouldn’t always happen on a bank holiday… it’s those kinds of services [which will be disrupted].’

The RCN balloted nurses at 300 NHS hospitals and trusts. 

However, not all 300 hospitals and trusts may be hit by strike action. 

At least half of nurses at each NHS organisation and trust need to vote in favour of industrial action for the strike to go ahead, which could trigger varying levels of service across the country. 

The senior health chief told the newspaper: ‘You might well have Nottingham that is on strike, and Derby isn’t. 

‘Derby would be providing a normal service but Nottingham would only be providing bank holiday and anything extra that they might agree to do locally,’ the source said. 

It is unclear when strikes will happen and how long they will last.

Like other workers, nurses can’t legally be sacked if they participate in official and lawful industrial action.

However, unlike other sectors, some nursing staff will continue to work. 

This is carefully negotiated with NHS bosses before the strike takes place to ensure patient safety.

For example, an entire service — such as an intensive care unit or night duty — may be exempt from the industrial action and continue working.

However, the walkout will involve theatre nurses, who play a major role in operations. 

That is likely to cause delays and cancellations for important planned procedures such as hip and knee replacements, leaving patients already hit by the Covid backlog waiting in pain for longer.  

Cabinet minister Oliver Dowden said the Department of Health had ‘contingencies’ in place for a strike and would prioritise the most essential services.

He told Sky News’ Sophy Ridge on Sunday programme: ‘I would continue to urge nurses and others to resist going out on strike, even if they have voted to do so.

‘We have already agreed quite considerable support for nurses.

‘Of course, if you are in the situation where you have a large number of nurses going out on strike, of course that is going to have an impact, for example on some elective surgery and other activities.’

The RCN is calling for a pay deal for its members employed by the NHS of 5 per cent above inflation, which is a total rise of around 17 per cent.

The amount offered to nurses in England and Wales by the Government, on the advice of the independent NHS Pay Review Body, is 3 per cent, or 4 per cent for an experienced nurse. 

This is on top of a 3 per cent pay rise in 2021, when wider public sector pay was frozen. 

There have been reports of nurses using food banks, struggling to afford to travel to work, or quitting the NHS for better paid jobs in shops and hospitality.

The NHS staffing crisis is also fuelling the strike action, with eight in ten nurses warning that there are too few medics to treat patients safely and effectively. 

The RCN said there are ‘record’ nursing vacancies and 25,000 nurses left the Nursing and Midwifery Council register. 

It is calling for more staff to reduce record waiting lists which have built up during the pandemic. 

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

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

NHS data shows efforts to get more nurses into the health service are only barely keeping pace with the number of experienced nurses quitting

Hundreds of thousands of nurses, paramedics and midwives across the UK are voting on whether to strike over pay and working conditions. Pictured: Nurse Margaret McCarthy, Unison Divisional Convener, protesting with NHS workers outside the Queen Elizabeth University Hospital in Glasgow on October 26, 2022

Hundreds of thousands of nurses, paramedics and midwives across the UK are voting on whether to strike over pay and working conditions. Pictured: Nurse Margaret McCarthy, Unison Divisional Convener, protesting with NHS workers outside the Queen Elizabeth University Hospital in Glasgow on October 26, 2022

RCN members are currently being balloted on a historic strike action, the first in the union's 106-year-history

RCN members are currently being balloted on a historic strike action, the first in the union’s 106-year-history

RCN boss Pat Cullen said nurses have been 'forced' into strike action due to a 'decade of real-terms pay cuts'

RCN boss Pat Cullen said nurses have been ‘forced’ into strike action due to a ‘decade of real-terms pay cuts’

NHS nurses strike action explained 

What is happening?

Britain’s nursing union, the Royal College of Nursing (RCN), asked 300,000 members to vote on strike action. Ballots closed on November 2.

What does the union want?

The union wants nurses to get a pay rise 5 per cent above inflation, which currently sits around 12 per cent. This is far above the Government’s offer of about 4 per cent.

What happens now the ballot is closed? 

The RCN will tally the votes per UK  nation with the results expected to be announced in the coming days. 

What result is needed for nurses to go on strike? 

Trade union laws differ per 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?

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 need 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. 

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. 

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.

Pat Cullen, the RCN’s general secretary and chief executive, said: ‘I want to thank members for taking the time to vote in this historic ballot.

‘Your vote is your voice, and we must use that voice. 

‘There has never been a more crucial time to fight for safe staffing and fair pay. Our NHS is on the precipice due to chronic staff shortages. 

‘Our profession is being pushed to the edge, with patient safety paying the price. 

‘None of us wants to take industrial action but we’ve been forced into this position after a decade of real-terms pay cuts. We can’t stand by and watch our colleagues and patients suffer anymore. Enough is enough.’ 

The RCN handbook says provision during the strike period should be equal to that on Christmas Day.

It did not allow strikes up until 1995, when it changed the rules to allow action so long as it was not detrimental to patients. 

A spokesman for the Department of Health and Social Care said: ‘We value the hard work of NHS staff including nurses and are working hard to support them – including by giving over one million NHS workers a pay rise of at least £1,400.’

The nurses’ strike could kickstart similar walkouts across the medical profession, with junior doctors, midwives and paramedics also mulling strikes.

The Royal College of Midwives has asked its 50,000 members to vote in support of industrial 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.

The BMA said it is ‘deeply concerned’ that continuing pay erosion will drive doctors out of the profession at a time of record backlogs and when the NHS ‘can least stand to lose them’. 

Discontent with pay and working pressures amid the cost of living crisis has seen rail workers strike for months and university staff set to strike.

Leanne Lewis, a nurse in Bridgend, Wales, who voted in favour of industrial action, said it was ‘an extremely difficult decision’.

Ms Lewis told BBC Radio Wales Breakfast programme: ‘I felt we needed to take action. Enough is enough.’

She said the NHS is ‘haemorrhaging staff’ and many are not working due to ‘burnout’ and ‘post-pandemic’ complications. Ms Lewis herself is off work and receiving half her pay due to long Covid. 

The situation means there are too few medics working on wards, creating ‘not safe’ staffing levels.

Ms Lewis said: ‘Nurses are absolutely traumatised and fed up of not being able to give the patient care they want to give and that they deserve.

‘It’s heart-breaking to have colleagues phoning me after a shift in tears because they feel they haven’t been able to provide the care they wish they could have due to not having the staff.

‘Staff are leaving the NHS and they’re going back into hospitals working on agency doing exactly the same role for sometimes double, quadruple the amount of wages purely because that’s the only way they can make ends meet.’

Ms Lewis said more needed to be done to encourage more people into the profession.

She said: ‘When I trained I had a small bursary of about £3,500 a year and the actual training was free. 

‘Nurses are having to pay now for their training through student loans.

‘They’re paying their day-to-day bills, travel expenses. There needs to some sort of compromise around pay and staffing numbers.

‘The Government needs to sit down with the RCA and other unions and have some serious discussions.’

WHAT PARTS OF THE NHS COULD STRIKE?

Nurses

The Royal College of Nursing (RCN) is urging its 300,000-plus members to vote in favour of strike action. Ballots close on November 2.

Junior Doctors 

The British Medical Association will ballot junior doctors in early January on whether it should strike over pay.

The BMA said it is ‘deeply concerned’ that continuing pay erosion will drive doctors out of the profession at a time of record backlogs and when the NHS ‘can least stand to lose them’.

Paramedics

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 be ahead of Christmas, it would be the biggest for three decades.

Midwives

The Royal College of Midwives has asked it 50,000 members to vote in support of industrial action when ballots open on November 11. 

Two-thirds have already said they would be willing to strike in a preliminary poll. 

Physiotherapists 

The Chartered Society of Physiotherapy (CSP) said more than eight in 10 of its 60,000 members are prepared to strike.

Members in Scotland must submit their ballot by October 31, with the CSP urging physios to vote in favour of action.

In England and Wales, voting will run from November 7 to December 12.

It makes the first time members have been balloted over pay in the CSP’s 100-year history.

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