Nurses in intensive care, cancer wards, and A&E departments will join NHS strikes in a significant escalation of the bitter pay dispute.
The Royal College of Nurses said excluding thousands of its members from the strike was “only prolonging the dispute” but the Government said its latest move will “risk patient safety”.
There will be a 48-hour walk out and industrial action will be expanded to over 120 NHS employers in England on March 1.
Previous nurse walkouts only lasted 12 hours.
The RCN will also include its members working in emergency departments who had also previously been exempt.
The union will make a limited set of provisions for the most urgent clinical situations as part of a legal obligation for “life and limb” cover.
However it will reduce services to an absolute minimum and ask hospitals to rely on members of other unions and other clinical professions instead.
RCN General Secretary Pat Cullen, said: “It is with a heavy heart that I have today asked even more nursing staff to join this dispute.
“These strikes will not just run for longer and involve more people but will leave no area of the NHS unaffected. Patients and nurses alike did not want this to happen.
“By refusing to negotiate with nurses, the Prime Minister is pushing even more people into the strike.
“He must listen to NHS leaders and not let this go ahead.”
Hospital leaders warned the ongoing industrial dispute could lead to “serious long term damage to the NHS” and called on ministers to open pay talks.
PM Rishi Sunak has refused to involve himself directly in the dispute while Health Secretary Steve Barclay has had repeated meetings with NHS unions at which he has refused to discuss the key issue of pay.
Mr Barclay said: “Failure to provide cover during strike action for key services like cancer care is a significant escalation from the Royal College of Nursing that will risk patient safety.
“We are working closely with NHS England on contingency plans, but this action will inevitably cause further disruption for patients.
“I’ve had a series of discussions with unions, including the RCN, about what is fair and affordable for the coming year, as well as wider concerns around conditions and workload.”
The RCN is now removing so-called “derogations” which had been negotiated at local level through committees of hospital staff and union reps.
These 5,000 exemptions excluded the requirement to strike for certain nurses but will now be scrapped.
The RCN is still in discussions with the NHS England leadership over what constitutes life and limb cover.
Ms Cullen added: “I will do whatever I can to ensure patient safety is protected.
“At first, we asked thousands to keep working during the strikes but it is clear that is only prolonging the dispute.
“This action must not be in vain. The Prime Minister owes them an answer.”
The move will see other clinical staff drafted in to replace nurses treating cancer patients and the most seriously ill.
It follows reports that some union reps felt hospital bosses had manipulated the derogation process to put pressure on nurses to break the strike.
The RCN will increase financial support for its striking members who lose wages by taking industrial action.
The initial strike benefit rate will be increased from £50 to £80 per day, with the rate increasing to £120 from the fourth day of action.
The Tories are sticking to their 4% pay award for England despite inflation running at over 10%.
Unions have accused them of dragging out the dispute in the hope that the public mood turns against striking medics.
Sir Julian Hartley, chief executive at NHS Providers, which represents hospital bosses, said: “This is the most worrying escalation of strikes yet.
“With more than 140,000 appointments already postponed as a result of the walkouts, this is a step no one wants to take.
“A continuous 48-hour strike with no exceptions in A&E, intensive care units or cancer care services will be a huge blow – especially as even more trusts will be affected this time.
“With further strikes by ambulance workers planned in the coming days and weeks, and junior doctors’ walkouts also likely, trust leaders are now in a near-impossible position.
“They’re deeply concerned the escalation could hamper their efforts to tackle care backlogs and compromise continuity of care for some.
“Without a resolution, this ongoing dispute could lead to serious, long-term damage to the NHS.”
The Government is pushing unions to forget about this year’s pay, and focus on the deal for 2023/24 financial year - for which the contested NHS Pay Review Body is yet to deliver a recommendation.
Unions have lost faith in the independence of the body and the process is notoriously slow, with Government providing its evidence for a restrained pay deal many months late.
Hospital bosses have already insisted ministers must settle the 2022/23 dispute before moving on to the next round of pay negotiations.
It comes as the NHS is under unprecedented pressure with record staff vacancies.
Sir Julian Hartley added: “We understand that frontline staff feel they’ve had no choice but to take this action due to challenges including the high cost of living, workforce shortages and below-inflation pay rises.
“Trust leaders will be working flat out to ensure patient safety and provision of vital services, but they can only do so much by themselves.
“The Government needs to talk to the unions urgently about pay for this financial year.”
Here is the list of employers where strike action will be taking place in March.
- East Midlands Derbyshire Community Health Services NHS Foundation Trust
- Derbyshire Healthcare NHS Foundation Trust
- East Midlands Ambulance Service NHS Trust
- Kettering General Hospital NHS Foundation Trust
- NHS Derby and Derbyshire ICB
- NHS Nottingham and Nottinghamshire ICB
- Northamptonshire Healthcare NHS Foundation Trust
- Nottingham University Hospitals NHS Trust
- Nottinghamshire Healthcare NHS Foundation Trust
- Eastern Cambridge University Hospital NHS Foundation Trust
- Cambridgeshire and Peterborough NHS Foundation Trust
- Cambridgeshire Community Services NHS Trust
- East Suffolk and North Essex NHS Foundation Trust
- Hertfordshire Community NHS 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
- Norfolk and Norwich University Hospitals NHS Foundation Trust
- Norfolk and Suffolk NHS Foundation Trust
- Norfolk Community Health and Care NHS Trust
- Royal Papworth Hospital NHS Foundation Trust
- West Suffolk NHS Foundation Trust
- London Great Ormond Street Hospital for Children
- NHS Foundation Trust Guys and St Thomas NHS Foundation Trust
- Hounslow and Richmond Community Healthcare NHS Trust
- Imperial College Healthcare NHS Trust
- King's College Hospital NHS Foundation Trust
- NHS North Central London ICB
- NHS South West London ICB
- Royal Marsden NHS Foundation Trust
- St George's University Hospitals NHS Foundation Trust
- Tavistock and Portman NHS Foundation Trust
- University College London Hospitals NHS Foundation Trust
- North West Alder Hey Children's NHS Foundation Trust
- Bridgewater Community Healthcare NHS Foundation Trust
- Cheshire and Wirral Partnership NHS Foundation Trust
- Countess of Chester Hospital NHS Foundation Trust
- Lancashire Teaching Hospitals NHS Foundation Trust
- Liverpool Heart and Chest Hospital NHS Foundation Trust
- Liverpool Women's NHS Foundation Trust
- Mersey Care NHS Foundation Trust
- Mid Cheshire Hospitals NHS Foundation Trust
- Midlands and Lancashire CSU
- NHS Cheshire and Merseyside ICB
- NHS Lancashire and South Cumbria ICB
- North West Ambulance Service NHS Trust
- St Helens and Knowsley Teaching Hospitals NHS Trust
- Tameside and Glossop Integrated Care NHS Foundation Trust
- The Christie NHS Foundation Trust
- The Clatterbridge Cancer Centre NHS Foundation Trust
- The Walton Centre NHS Foundation Trust
- Wirral Community Health and Care NHS Foundation Trust
- Wirral University Teaching Hospital NHS Foundation Trust
- Wrightington Wigan and Leigh NHS Foundation Trust
- Northern Country Durham and Darlington NHS Foundation Trust
- Gateshead NHS Foundation Trust
- North of England Commissioning Support (NECS)
- North East Ambulance Service NHS Trust
- Northumbria Healthcare NHS Foundation Trust
- South Tees Hospitals NHS Foundation Trust
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust
- University Hospitals of Morecambe Bay NHS Foundation Trust
- South East East Sussex Healthcare NHS Trust
- Kent Community Health NHS Foundation Trust
- NHS Kent and Medway ICB
- NHS Surrey Heartlands ICB
- Queen Victoria Hospital NHS Foundation Trust
- South East Coast Ambulance Service Sussex Community NHS Foundation Trust
- Sussex Partnership NHS Foundation Trust
- University Hospitals Sussex NHS Foundation Trust
- Oxford Health NHS Foundation Trust
- Oxford University Hospitals NHS Foundation Trust
- Portsmouth Hospitals NHS Trust
- Royal Berkshire NHS Foundation Trust
- Solent NHS Trust
- South Central Ambulance Services NHS Foundation Trust
- Southern Health NHS Foundation Trust
- University Hospital Southampton NHS Foundation Trust
- South West Avon and Wiltshire Mental Health Partnership NHS Trust
- Cornwall Partnership NHS Foundation Trust
- Devon Partnership NHS Trust
- Dorset County Hospital NHS Foundation Trust
- Dorset Healthcare University NHS Foundation Trust
- Gloucestershire Health and Care NHS Foundation Trust
- Gloucestershire Hospitals NHS Foundation Trust
- Great Western Hospitals NHS Foundation Trust
- NHS Bath, North East Somerset, Swindon and Wiltshire ICB
- NHS Devon ICB (One Devon)
- NHS Dorset ICB (One Dorset)
- NHS Gloucestershire ICB (One Gloucestershire)
- North Bristol NHS Trust
- Royal Cornwall Hospitals NHS Trust
- Royal Devon University Healthcare NHS Foundation Trust
- Royal United Hospitals Bath NHS Foundation Trust
- Salisbury NHS Foundation Trust
- Somerset NHS Foundation Trust
- South Western Ambulance Service NHS Foundation Trust
- Torbay and South Devon NHS Foundation Trust
- University Hospitals Bristol and Weston NHS Foundation Trust
- University Hospitals Dorset NHS Foundation Trust
- University Hospitals Plymouth NHS Trust
- West Midlands Birmingham Women's and Children's NHS Foundation Trust
- Dudley Integrated Health and Care NHS Trust
- Herefordshire and Worcestershire Health and Care NHS Trust
- Midlands Partnership NHS Foundation Trust
- NHS Birmingham and Solihull ICB (BSol ICB)
- NHS Black Country ICB
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
- Shropshire Community Health NHS Trust
- The Royal Orthopaedic Hospital NHS Foundation Trust University Hospitals
- Birmingham NHS Foundation Trust
- Worcestershire Acute Hospitals NHS Trust
- Yorkshire and the Humber Barnsley Hospital NHS Foundation Trust
- Bradford Teaching Hospitals NHS Foundation Trust
- Harrogate and District NHS Foundation Trust
- Leeds Community Healthcare NHS Trust
- NHS North West Yorkshire ICB
- Sheffield Children's NHS Foundation Trust
- Sheffield Health and Social Care NHS Foundation Trust
- Sheffield Teaching Hospitals NHS Foundation Trust
- The Leeds Teaching Hospitals NHS Trust
- York and Scarborough Teaching Hospitals NHS Foundation Trust
National employers
- Health Education England
- NHS Blood and Transplant
- NHS England NHS Resolution
