Nurses on Thursday walked out for the fourth time as a union leader said they were "stretched beyond belief" by the crisis in Britain's hospitals.
Members of the Royal College of Nursing (RCN) began a second consecutive day of strike action at 55 trusts in England in a bitter dispute over pay.
In London, strike action was underway from 8am at Hounslow and Richmond Community Healthcare NHS Trust, St George's University Hospitals NHS Foundation Trust, Kings College Hospital NHS Foundation Trust and University College London Hospitals NHS Foundation Trust.
Further industrial action will take place on February 6 and 7.
Mark Farmer, the RCN’s interim London Director, told the Standard that the union would continue to strike until ministers “open a dialogue with us” on pay. The RCN does not have any meetings scheduled with Health Secretary Steve Barclay after talks failed to yield a settlement last week.
“The flexibility we are showing is not being met by any significant or any real dialogue from Government,” he said.
“It’s all in their hands now.”
The RCN has been calling for a pay rise at 5 per cent above inflation, though it has said it will accept a lower offer.
London hospitals are in the grip of their worst ever winter crisis, with record waits for treatment in A&E and for ambulances.
Mr Farmer said the situation had left many nurses in a state of “acute distress”.
“Our London members are stretched beyond belief. A&E departments are under huge pressure and nurses feel that they are not giving the care they want to give. They are often distraught when they stop and think about what their work is really like.
“They cope on shift, but the emotional distress is unbearable sometimes. That’s why so many are considering leaving the profession.”
A union source said that wait times for the RCN’s counselling service, which offers mental health support to nurses, were “off the charts”.
“The demand is really high and we’ve seen it increase exponentially since the pandemic.”
Figures published last week revealed that the number of NHS staff leaving the health service citing health reasons, a lack of opportunities and "incompatible working relationships" had nearly doubled in two years up to September 2022.
Levelling Up Secretary Michael Gove said the Government must balance striking nurses’ pay demands with “recognising we also have to be careful stewards of public money”.
But he denied controversial claims by Tory MP Simon Clarke that nurses using foodbanks were “not budgeting properly”.
Mr Gove told Sky News: “I would never criticise nurses for something like that, I think the most important thing to do is to recognise that people who are working in the NHS are people who’ve dedicated their lives to a caring profession.”
Royal College of Nursing general secretary Pat Cullen said her members had been left “deeply disappointed” after Mr Barclay ruled out a compromise 10 per cent pay settlement on Wednesday which the nursing union hoped would end the dispute.
Meanwhile, NHS bosses on Wednesday night expressed “deep concern” after several health unions announced strike action on the same day next month.
Thousands of ambulance workers from the GMB union and nurses will walk out on February 6 – meaning mass disruption can be expected across the NHS.
Commenting on the combined strike action, Saffron Cordery, interim chief executive of the NHS Providers organisation, said: “It could be the biggest day of industrial action the NHS has ever seen.”
Matthew Taylor, chief executive of the NHS Confederation, said that prolonged strike action due to the deadlock would leave the NHS trapped in a "vicious cycle".
“If there is no realistic prospect of a solution, then we’re facing the prolonged war of attrition between the government and the unions that we’ve been fearing."
Health and Social Care Secretary Steve Barclay said: “Patients will understandably be worried by the prospect of further strike action by nurses - the previous two days of nurse strikes saw around 30,000 elective procedures and outpatient appointments cancelled. It is inevitable industrial action will have an impact on patients.
“I have had constructive talks with the Royal College of Nursing and other unions about the 2023/24 pay process and look forward to continuing that dialogue.”