A nurses union leader has warned that the NHS will not be "fit for purpose" if the "crisis in nursing" which has led to historic industrial action is not urgently addressed.
Royal College of Nursing (RCN) General Secretary Pat Cullen said that "we have pushed nurses to the brink", as she described how some low-paid workers felt humiliated for having to pick up food parcels at foodbanks after long and gruelling shifts.
Calling the strike over pay a "defining moment" in the nursing profession, the union boss said that patients and the general public "deserve better".
"They have turned their anger into action on behalf of their patients," she told ITV's Good Morning Britain on Thursday.
'We are not going to have a health service that is fit for purpose,' Ms Cullen said
"If we do not address the crisis in nursing, and if we don't address it through treating them decently with a proper pay wage, that they can look after their families and stop living on a knife-edge at home, and then when they come into work and having to worry about looking after their patients, then we are not going to have a health service that is fit for purpose and our patients are not going to be treated properly," she added.
She said the reasons why many patients are on long waiting lists is because the nursing workforce has been "depleted" year on year, with 47,000 vacant nursing posts in England alone.
During industrial action, the health service will turn its attention to treating emergency patients in a “life-preserving care model”, with sources saying some hospitals on strike days will have staffing levels similar to those over Christmas.
Some of the most serious cancer cases could still be treated, while urgent diagnostic procedures and assessments will be staffed if they are needed to gather data on potentially life-threatening conditions or those that could lead to permanent disability.
Ms Cullen confirmed that maternity services will not be affected by the action.
While urgent and emergency care will also be protected, the strikes will impact on routine services, such as planned operations, including knee and hip replacements, district nursing and mental health care.
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 he admitted that some operations and appointments will have to be cancelled or postponed.
Mr Taylor 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.”
Mr Taylor added that 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.”
Asked about the current state of nursing in the NHS, Mr Taylor said “we are acutely aware of the fact that health workers take industrial action as a last resort – it’s very rare.”
He said the issue is primarily about pay but “it’s important to understand that, whenever you speak to nurses, they will say pay is part of the challenge but it’s also about workload, about the fact that there are nearly 50,000 nurse vacancies across the NHS.
“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.”
RCN strike action will take place at these locations
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
Cambridgeshire and Peterborough NHS Foundation Trust
Norfolk and Norwich University Hospitals NHS Foundation Trust
Cambridge University 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
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 & The Humber
Yorkshire & 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
Patricia Marquis, RCN director for England, told BBC Breakfast that current NHS services were “not safe” and the government has “failed to listen” to what nursing staff have been saying.
She said there are some services that need to continue during strike action to keep patients safe “and we will agree with employers what those are and which staff should be working”.
She added that employers across most of the UK needed 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.”
Industrial action is expected to be held before the end of the year at some of the UK’s biggest hospitals, including Guy’s and St Thomas’ opposite Parliament, the Royal Infirmary in Edinburgh, University Hospital Wales, and Belfast’s Royal Victoria.
The RCN announced on Wednesday that its members in the majority of NHS employers across the UK have backed industrial action.
The strike will be the first time UK-wide action is taken by RCN members in its 106-year history.
Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To Know
Several health worker unions including Unison and the GMB will announce the result of strike ballots before the end of the month among staff including ambulance drivers and paramedics, hospital porters and cleaners.
Physiotherapists started voting on Monday over industrial action, while a ballot of midwives opens on Friday.
The unions are protesting over a pay award earlier this year of £1,400 for most NHS workers, with the RCN calling for a rise of 5% above the rate of inflation.
Health Secretary Steve Barclay branded the decision to take industrial action “disappointing,” insisting the RCN’s demands are “out of step” with the economic situation faced by the UK.