Hospitals across Wales face major disruption on Thursday as nurses in Wales walk out for the first time in history in a row over pay. Union members of the Royal College of Nurses in Wales will be striking on Thursday December 15 and on December 20 after voting in November to strike for the first time in history.
Nurses in all but one health board in Wales will be striking on Thursday. Aneurin Bevan University Health Board members voted to strike but did not reach the 50% turnout threshold needed for industrial action. The historic strikes will see hospitals, ambulance services and other nursing services such as home care severely impacted with thousands of outpatient and routine surgeries and appointments set to be cancelled. Urgent care such as cancer treatment will go ahead as normal.
Welsh health minister Eluned Morgan met with union officials on Monday in a bid to stave off strike action but no agreement was reached. The union claims an experienced nurse has seen their pay decline by at least 20% in real terms due to successive below-inflation awards since 2010 and has asked for 5% above the RPI rate of inflation which stands at over 12%. Welsh Government claims it cannot afford to increase pay without the UK government putting more money on the table.
Read more: Every strike date planned for the rest of the year including nurses, posties and rail workers
Nurses in England and Northern Ireland are also joining picket lines on Thursday. Nurses from two major NHS unions in Scotland - Unite and Unison - will no longer strike after its members accepted a 7.5% pay deal earlier this week. If you live in Wales and you have an appointment this Thursday, you will be contacted directly by the health board if your appointment or surgery is not going ahead. Ongoing talks between health boards and union officials over which services will run mean that you might not be contacted about your appointment until the day before the strike. Here is everything you need to know about the nurses' strike including which services will be affected in each area of Wales and how you will be impacted.
Why are nurses going on strike?
The RCN says nurses are "significantly worse off" than they were ten years ago and that the number of vacancies for registered nurses in NHS Wales has risen to an unprecedented 3,000. It said the union's dispute with the Welsh Government is about pay and patient safety with the high number of vacancies putting patients at risk. In July the lowest-paid nurses in Wales were offered a £1,400 flat pay increase, but unions have repeatedly argued this is not enough.
The union claims an experienced nurse has seen their pay decline by at least 20% in real terms due to successive below-inflation awards since 2010 and has asked for 5% above the RPI rate of inflation which stands at over 12%. The Welsh Government says it cannot afford this with a spokesperson saying this week: "We recognise the difficult position of those who work in the NHS in Wales and the strength of feeling. However, without additional funding from the UK Government we are not able to make an increased pay offer without risking a reduction in services.
“While we were unable to avert the forthcoming industrial action, all partners have agreed to keep talking and to continue to work together on key issues."
What services will be affected on Thursday?
Although thousands of staff will not work on Thursday, the RCN has agreed a number of hospital services which will go ahead as normal and will not be affected by the strikes. They are:
Chemotherapy
Dialysis
Critical care units such as intensive care and high dependency)
Neonatal and paediatric intensive care
Paediatric A&E
These services are 'derogations' meaning they are exempt from strike action due to their critical nature, as not having the staff to run these services would potentially put patient safety at risk. While these services will be running across all hospitals in Wales, other non-urgent services are more likely to be impacted. Health boards have been in talks with union officials in recent days to determine which services will be impacted, but these are expected to vary slightly depending on the health board and the needs of individual patients. It is therefore not possible to list exactly which other services will be affected.
But it is understood the likes of orthopaedic routine appointments, non-urgent surgeries and follow-up medical outpatient appointments will be among the services heavily impacted on Thursday. Some health boards have outlined which services are cancelled on Thursday. However, some appointments and surgeries will be going ahead. You will be contacted by your health board if yours is being postponed.
It is not clear exactly how many appointments and surgeries are cancelled due to the strikes, as the services which are running vary depending on the health board and, in some situations, on an individual case-by-case basis. To use recent figures for context, approximately 1,200 elective inpatient/day case appointments were undertaken each working day on average across Wales in September. This number includes cancers and urgent operations, which are expected to continue during industrial action.
In Wales there were approximately 3,900 new appointments and 8,000 follow-up appointments per working day in September. A proportion of these are cancelled on Thursday, but again these figures include cancer treatment which is continuing as normal.
How services will be affected where you live
Aneurin Bevan University Health Board services will run as normal as staff in that health board are not striking due to having failed to reach the 50% turnout required for industrial action.
Cardiff and Vale University Health Board has cancelled non-urgent outpatient appointments and procedures but said it was committed to continuing urgent cancer care. It said: "We appreciate this may be frustrating for our patient groups, especially where there have been long waits for treatment but we hope the public understand we need to keep services safe.
"All patients who are expecting treatment or appointments on either December 15 or 20 will be contacted via text message to inform them if their appointment is going ahead or if it is cancelled. Any appointments that are cancelled will be rearranged and patients will be contacted with a new date. Follow up letters will be sent in the post to confirm this and our teams may also reach out to those affected by phone call."
Swansea Bay University Health Board said most scheduled operations and outpatient appointments will be postponed with the exception of cancer day unit for chemotherapy treatments, radiotherapy, haematology, oncology; radiology – x-rays, MRI scans, CT scans, ultrasound scans; phlebotomy such as blood tests; cardiac physiology such as heart scans and ECGs; virtual outpatient appointments; audiology, speech and language therapy; podiatry and orthotic, physiotherapy, occupational therapy and dietetic; and MCAS/CMATS. The health board is asking anyone with an appointment that is not within a service listed above not to turn up as you will not be seen. The only exception to this is in a few cases where you will be contacted directly if your appointment is still going ahead.
Cwm Taf Morgannwg University Health Board said emergency department and critical care services will continue to be available for the most serious and urgent patients while patients expecting planned treatment or inpatient surgery will be rearranged as soon as possible.
In addition, all community vaccination centres in the health board area will be closed for the day for all immunisation appointments. Those affected by this closure have been informed, their appointments cancelled and new appointments sent out. There will also be no walk-in appointments on December 15. December 20 is currently being considered and will be confirmed in due course. Patients with planned treatment or appointments on the strike days affected are being contacted directly by respective booking teams with details about rearranged appointments.
Betsi Cadwaladr University Health Board executive director of nursing Angela Wood said members of the public should not call the health board enquiring about any planned appointments on the day of action and that patients will be contacted if there are any changes to treatment or appointments. “Patients due to attend our acute sites and those in the community on Thursday, December 15, should attend as normal, unless advised by our staff not to do so," she said.
“For anyone affected, alternative dates will be found and I thank them for their understanding as we work through those arrangements. Those due to undergo some other planned inpatient surgery will be reappointed as soon as possible."
Hywel Dda University Health Board said chemotherapy Units will be operating as normal on strike days and some surgery for urgent cases will take place at its hospitals. Where appointments need to be re-scheduled, patients are being contacted by the relevant team to re-arrange their appointment as quickly as possible. In some cases, this may mean bringing appointments forward. Some face-to-face outpatient appointments will still go ahead and some may be held as an online or virtual appointment.
If you have an appointment on Thursday December 15 and have not been contacted, you should assume that your appointment will go ahead. The health board is contacting all patients by telephone or text message. Most GP surgeries, community pharmacies and dental services will continue to operate as normal on December 15 and 20. Some community based services will be impacted by the industrial action but urgent services including priority district nursing and the acute response team will continue to operate. If there is a change to your community-based appointment on Thursday December 15, the team will contact you to rearrange your appointment. Mass vaccination centres will not be offering drop-in sessions on December 15 and 20 but some community vaccinations will continue. All urgent and emergency care services will continue as normal.
Powys Teaching Health Board said planned appointments will go ahead as normal on Thursday December 15 unless you have been contacted to rearrange. Its minor injury units are offering a Bank Holiday service on Thursday:
- Brecon War Memorial Hospital: 24 Hours (Phone First: 01874 615800)
- Llandrindod Wells Memorial Hospital: 0700-midnight (Phone First: 01597 828735)
- Welshpool Victoria Memorial Hospital: 0800-2000 (Phone First: 01938 558919 or 01938 558931)
- Ystradgynlais Community Hospital: Closed
The health board's minor injury units offer a “phone first” service. If you 'phone first' you will have a telephone assessment and advice and be booked in for an appointment as appropriate or referred to an alternative service. However the health board said a walk-in service continues to be available.
Should I go to my appointment on Thursday?
Health boards have assured patients that they will be contacted if they have appointments on Thursday which cannot go ahead, but in some cases patients might not be contacted until the day before their appointment. If you have an appointment - especially if it relates to one of the services exempt from the strike - and you have not been contacted by your health board, you should go to your appointment as planned.
What if I have an emergency on a strike day?
Anyone who needs urgent assistance or has a life-threatening situation is advised to attend emergency departments or contact the emergency services as normal. Anyone with a non-life-threatening condition will be asked to use the NHS Wales 111 digital service in the first instance but are advised that these services will also be slower due to many 111 clinicians being nurses.
Welsh Ambulance Services NHS Trust said services will be affected and has asked the public to use services sensibly on Thursday. "During any strike action emergency care is still a priority and emergency services will still be available, although less serious incidents or illnesses may not receive a response," it said.
"As always, anyone who wants medical advice, their first port of call should be to go to NHS 111 Wales online unless it’s very serious or life-threatening. On days where there is strike action, patients should, more than ever, only call 999 for very serious or life-threatening emergencies where an ambulance is the only appropriate choice." If calling 111, on days when nurses strike there may be fewer clinicians available as many 111 clinicians are nurses. This means that you may wait longer to be assessed and to receive a call back.
Will the next strike on December 20 go ahead as planned?
At the moment it is likely that next week's strike will go ahead. Both the RCN and Welsh Government remain open to coming back to the table, but unless a substantial new deal is put on the table it appears unlikely an agreement will be reached. On Thursday the Welsh Government announced its draft budget outlining its spending plans for 2023/24 which finance minister Rebecca Evans described as "unlike any since the start of devolution". Ministers have been clear about how difficult the current economic situation is owing to Brexit, inflation, the war in Ukraine and other pressures, and the UK government has so far failed to come up with extra money to address pay. It is therefore unclear where any money would come from in the event of a new deal being proposed. You can read the main takeaways from Tuesday's draft budget here.
Will this impact on NHS waiting lists in Wales?
Almost certainly, yes. The health service has been under increasing strain for many years and in October WalesOnline reported on the huge waiting lists in each part of Wales. Figures show there are more than 60,000 cases in which people are waiting more than two years for treatment whereas in England there are now fewer that 200 open waits for treatment. With thousands of appointments and surgeries needing to be rescheduled, it is likely to place further pressure on health staff in the coming month, especially over the busy Christmas period.
READ NEXT:
