ITV News Health Editor Emily Morgan has the latest developments on the first of two day-long nursing strikes over pay
Tens of thousands of nurses are going on strike for the first time across England, Wales and Northern Ireland.
Picket lines are being set up at dozens of hospitals in a dispute over pay, with the Welsh government saying services will be “significantly impacted”.
Thousands of NHS appointments and operations have been cancelled because of the strike, with the health service running a bank holiday-style service in many areas.
Around a quarter of hospitals and community teams in England are taking part in the strike, alongside all trusts in Northern Ireland and all but one health board in Wales.
The Royal College of Nursing (RCN) has said it will still staff chemotherapy, emergency cancer services, dialysis, critical care units, neonatal and paediatric intensive care.
Some areas of mental health and learning disability and autism services are also exempt, while trusts have been told they can request staffing for specific clinical needs.
When it comes to adult A&E and urgent care, nurses will work Christmas Day-style rotas.
Saffron Cordery, interim chief executive of NHS Providers, said NHS trusts were “pulling out all the stops” to lessen the impact on patients.
She said: “The picture will vary across the country as trust leaders work out service levels with unions locally.
“But it’s inevitable that some operations or appointments will have to be rescheduled and trusts are pulling out all the stops to minimise disruption.
“The cold snap has ramped up demand that was already at or close to record levels, but on strike day NHS trusts will do everything they can to ensure that essential services are properly staffed and patient safety, always the number one priority, is safeguarded.”
RCN chief executive Pat Cullen has accused Health Secretary Steve Barclay of “belligerence” after he refused to discuss the issue of pay.
He has repeatedly said the government is sticking to the recommendations of the independent pay review body, which said nurses should get a pay rise of around £1,400.
The RCN has been calling for a pay rise at 5% above inflation, though it has indicated it would accept a lower offer.
When it submitted the 5% figure to the independent pay review body in March, inflation was running at 7.5%.
But inflation has since soared, with RPI standing at 14.2% in September.
'We have to find that money from somewhere,' Maria Caulfield said as she defended the government's pay position
Health Minister Maria Caulfield said she recognises pay is "an issue" for nurses, but insisted that the government gave them a 3% pay increase last year when no other public sector worker received one.
When pressed that the current offer is below inflation and does not take into account soaring living costs, Ms Caulfield, who has also worked as a nurse, said "realistically a 19% pay rise is not achievable".
"At the moment we just don't have 10 billion pounds to give that 19% increase," she told ITV News Political Correspondent Libby Wiener.
The Lewes MP admitted the issue is a "difficult" one for the government.
However, she argued that increasing pay would mean either borrowing, increasing taxes for ordinary families or taking money from the existing budget, which could negatively impact frontline services.
'Something has to give': ITV News Health Editor Emily Morgan says nurses are 'desperate' for a resolution
Shadow Justice Secretary Steve Reed said it is "shocking" that Mr Barclay "refused" to sit down with the nurses to talk about the "crisis" and resolve the row over pay and conditions. "So, in a very real sense, the strikes happening today are Steve Barclay and Rishi Sunak strikes because the nurses gave them a way out and they simply refused it," he told ITV News. Mr Reed added that Labour would help make the NHS "work better for less", thereby freeing up resources for "fair pay rises". He claimed that the current government is in "hibernation".
Meanwhile, in Scotland RCN members are being consulted on a revised pay offer from the Scottish government.
Ms Cullen described today as a "tragic" one for nursing and patients, but insisted that it is the government that has left nurses "out in the cold" and are the only ones who can resolve the dispute through proper negotiation.
She told ITV News the nurses are "reasonable people", only asking for a "decent wage" to look after their families and pay their bills.
Pat Cullen said nurses are not 'greedy' people looking to line their 'pockets with gold'
Speaking outside Bristol Royal Infirmary, Ms Cullen invited the health secretary to come and join striking nurses, as she described a "depleted" workforce stretching nurses to their limits.
"What I would suggest to the secretary of state today: come out of your warm office, put on your coat, come to Bristol, walk amongst these hundreds of nurses that you have pushed out into the cold and onto picket lines.
"And you will come back feeling very very different. I think you will make different decisions."
The government have argued giving pay rises to nurses would stoke inflation.
The RCN has also raised the issue of huge staff vacancies in the NHS, with 47,000 nurse vacancies in England alone.
During the strike, nurses will man picket lines at major NHS hospitals, including Guy’s and St Thomas' NHS Foundation Trust in London, Addenbrookes Hospital in Cambridge and University Hospitals Birmingham NHS Foundation Trust.
A handful of nurses are already gathered on the picket line outside St Thomas’ Hospital in Westminster, central London in the dark and cold ahead of the Royal College of Nursing (RCN) strike starting at 8am.
On the picket line outside, Linda Tovey, a critical care nurse, said: “It’s increasingly difficult to come to work and go home and think ‘Actually I don’t think I can turn the heating on’."
Outside Aintree University Hospital in Liverpool, nurses gathered in freezing temperatures to join the picket line from 7.30am.
Liverpool staff nurse Kelly Hopkins, who has been a nurse for 25 years, said she felt “sad” when she went into work.
She added: “I have connections with the food bank and there are more and more nurses using the food bank which is just not acceptable."
Pamela Jones, striking for the first time in her life, was on the picket line outside Aintree University Hospital. She said she had been a nurse for 32 years and the changes she had seen were "astronomical".
“We want to save our NHS, we don’t want it to go, and I think this is the way forward, it’s the only way we can put our point across," Ms Jones said.
She added: “I hope the government listens, because none of us want to be here, we just want a fair pay rise.”
Mr Barclay said nurses were “incredibly dedicated to their job” and “it is deeply regrettable some union members are going ahead with strike action”.
He added: “My number one priority is to keep patients safe – I’ve been working across government and with medics outside the public sector to ensure safe staffing levels – but I do remain concerned about the risk that strikes pose to patients.
“Nevertheless, the NHS is open and patients should continue to seek urgent medical care – and attend appointments – unless they’ve been contacted by the NHS.”
He said paying nurses more “would mean taking money away from frontline services at a time when we are tackling record waiting lists as a result of the pandemic.”
But pressure is mounting on the government find a compromise on pay, with former Conservative Party chairman Sir Jake Berry saying it “is going to have to improve its offer”.
“We need to find a way as a government, and the union does too, to get to that centre point, that point of agreement straight away,” he told Talk TV.
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Several trusts have already given details of cancelled outpatient appointments and planned treatments.
The Western Trust in Northern Ireland said it had “regrettably taken the decision to cancel some non-emergency services”, with 587 outpatient appointments postponed across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital.
Some eight planned inpatient and day case procedures have also been cancelled.
The trust said there would also be reduced staffing in community nursing services including rapid response nursing, district nursing, community respiratory nursing and continence services.
In Wales, the Welsh government said non-urgent or routine appointments are likely to be postponed.
Meanwhile, the Walton Centre NHS Foundation Trust, the only specialist hospital trust in the UK dedicated to neurology, neurosurgery, spinal and pain management services, said outpatients and some elective treatments have been postponed or cancelled, but other patients should attend as normal.
Kettering General Hospital said it will be “stepping down some planned services and those patients affected will be contacted directly by our hospital”.
On Wednesday, the head of NHS Employers said “real concerns” remain about the level of cover nurses will provide for cancer patients during the strike.
In a letter to NHS leaders, Danny Mortimer said some aspects of talks with the RCN had been disappointing and warned that “unless the government indicates a willingness to negotiate on pay-related matters, further strike dates will be announced by the RCN for January 2023 and beyond”.
A second RCN nurse strike is set for December 20, while thousands of ambulance workers will go on strike on December 21.
The RCN has urged agency workers not to cover for striking staff.
Elsewhere, midwives and maternity support workers in Wales have voted to strike, though the ballot in England did not meet the legal turnout threshold.