NHS trusts are preparing for 'bank holiday' services on strike days after nurses voted for industrial action over a pay dispute.
Several healthcare workers in Merseyside hospitals told the ECHO they're expecting nurse staffing levels akin to a weekend or bank holiday when nurses go on strike later this year, possibly over Christmas. Dates are yet to be confirmed, but hundreds of nurses in Liverpool will take part in industrial action after the Royal College of Nursing (RCN) balloted its 300,0000 NHS workers for strike for the first time since since it was founded in 1916.
The dispute is over the government's offer of an average pay rise of 4.75% to nurses in England and Wales next year, which is a real-terms pay cut due to prices rising at the fastest rate in 40 years. The RCN is calling for a pay rise of five percentage point above inflation - an almost 17% pay increase.
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This would cost £9b extra if applied to all staff on the Agenda for Change contract, including nurses, paramedics and cleaners, according to the Department of Health and Social Care. Prime Minister Rishi Sunak described a 17% increase as "not affordable".
Nurses earn between roughly £25,000 and £39,000 a year. Despite a 3% pay increase in 2021 when public sector pay was frozen, nurses' wages are worth 20% less in real terms than they were a decade ago, according to the RCN. The union said a higher pay rise is needed "to overcome those real-terms pay cuts, support nursing staff through the cost-of-living crisis and recognise their safety critical skills".
Some nurses also see industrial action as a protest against staff shortages and the stressful working conditions this puts nurses under. Carmel O'Boyle, a frontline nurse in Liverpool, said nurses are working extra shifts and coming to work feeling run down to keep services going amid the largest ever shortage of nurses in the UK.
The nearly 47,000 unfilled vacancies in the UK are due in part to nurses leaving for higher paid roles in other sectors or abroad, while some nurses who stay take on second jobs. Carmel, 41, works part-time teaching clinical skills at Liverpool John Moores University while also serving as chair of RCN North West and studying in her own time. She doesn't "know nurses who can bumble by without having to put extra shifts in".
The nurse said the short-lived Health Secretary Thérèse Coffey's suggestion nurses could leave the country in search of better pay and opportunities "if they want to", shortly before the RCN's ballot opened, was the final straw pushing nurses into voting for strike action.
Carmel told the ECHO: "I'm angry we've been put in this position by the government. I'm really sad because it's the last thing any nurse wants, to be forced into this. And we are forced into this because the government hasn't listened to us.
"I'm also really proud that nurses have finally stood up and said, 'You know what, enough is enough, we can't do this anymore'. I've said for a long time, the NHS runs on goodwill and cups of tea of the healthcare profession family, and they can't go on like this.
"It's taken a lot to get to this point where nurses have said, 'Okay, we'll go on strike'. I'm not sure if people realise how momentous it is. This is the first time in 106 years that we've balloted the whole country. We're hearing from nurses right across the board, and all our healthcare professionals, that people are in real trouble.
"We have nurses in Liverpool using foodbanks. That's just an abomination. Because the pay isn't in line with inflation, and because people are struggling, we can't recruit into the profession.
"We need those people in the NHS, we need people to work and to help us care for patients, so if we're losing people because they're going elsewhere to find better money, then patients suffer. Every day that every one of us is on shift, the staffing is short and we're all under pressure in order to give that care. Patient safety is at the forefront of any nurse's mind, and the reality is the patients are suffering."
Given the role nurses play running testing and treatment services, caring for patients in hospitals or at home, and working in operating theatres, many are worried about the impact of a strike on the health and wellbeing of patients. Patient safety is also in the minds of nurses going on strike.
The RCN said any industrial action must follow a "life-preserving care model", which exempts emergency care, urgent diagnostic procedures and assessment for life-threatening conditions, and treatment preventing death or disability, from strike action.
When nurses went on strike in Northern Ireland in 2019, members working on services like intensive care units were exempt from participating in the strike, while others ran Sunday or Christmas Day services, or had night duty numbers working the day shift.
The strike will only take place at trusts where there was a 50% turnout in the RCN's strike ballot. In our region, this includes:
- Mersey Care NHS Foundation Trust
- Liverpool Heart and Chest Hospital NHS Found Trust
- The Clatterbridge Cancer Centre NHS Found Trust
- Countess of Chester Hospital NHS Foundation Trust
- North West Ambulance Service NHS Trust
- Liverpool University Hospitals NHS Foundation Trust
- Wirral Community Health and Care NHS Foundation Trust
- Wirral University Teaching Hospital NHS Found Trust
- Liverpool Women's NHS Foundation Trust
- St Helens and Knowsley Teaching Hospitals NHS Trust
- Alder Hey Children's NHS Foundation Trust
- The Walton Centre NHS Foundation Trust
- NHS Cheshire and Merseyside ICB
- Cheshire and Wirral Partnership NHS Foundation Trust
In the case of a strike involving walk outs, the ECHO understands the Aintree, Broadgreen and Royal Liverpool hospitals would operate a Bank Holiday-type service like the one implemented at short notice for Queen Elizabeth II's funeral on September 19.
This reduction in the number of nurses could see routine outpatient clinics and investigations like endoscopies delayed, with routine operations cancelled, while life-saving services like emergency departments and intensive care units operate as normal.
The RCN is required to give 14 days notice before commencing industrial action, giving health services time to prepare for walk outs or work-to-rule. NHS England is working with healthcare providers, professional bodies and trade unions to agree a safe level of cover, according to a Department of Health and Social Care spokesperson.
Preparations include a multi-day exercise, dubbed Exercise Arctic Willow, from the week starting Monday, November 14. The test-run will see if NHS integrated care boards and trusts can continue running services safely under "multiple, concurrent operational and winter pressures", including strikes.
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% 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."
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