Nurses could announce a wave of new strikes in January as soon as next week as their union leader warns they will fight to “the bitter end”.
Tory ministers face deafening demands to rethink NHS pay after the first nationwide walkout in the Royal College of Nursing’s 106-year history began this morning.
Tens of thousands of nurses are away or on picket lines today, on December 20 or both.
General secretary Pat Cullen said there is a “very strong possibility” fresh strike dates will be announced for January if the Health Secretary does not reopen pay talks.
The union must give two weeks’ notice - so dates could be announced before Christmas.
Ms Cullen said nurses are going to food banks and “waiting until their patients eat so then they can eat what's left over. What a way to treat this profession.”
She added: “I woke up this morning very, very early and felt heartbroken as a nurse.
“It's tragic for nursing, it's tragic for patients and it's tragic for the NHS, that the Government feels that they can sit in their offices today and keep our nurses out in the cold."
Ex-Tory chairman Jake Berry warned Rishi Sunak ’s 4.75% pay offer for nurses was too low and he must now “meet somewhere in the middle” of their 19% demand.
“I can tell you that the government offer is too low,” he told TalkTV. “The government is going to have to improve its offer.”
England’s chief nursing officer Dame Ruth May appeared to back striking nurses on the picket line.
And the former head of the NHS pay review body said ministers should ask it to reconsider the pay rise - which was recommended before inflation soared.
Jerry Cope told BBC Radio 4’s Today programme: “The world was a rather different place in February.
“And therefore I think some of the evidence they considered was probably out of date by the time it was published.
“I think they (ministers) should… actually say I want you to do a very quick turnaround for this year's recommendations.
STRIKE MAP WIDGET: Enter your postcode below and hit the READ MORE button to see the nearest hospital to you where nurses are going on strike
“And I want you to take account on anything you might have missed last time round. I think it's a way out because it respects the integrity of the pay review body."
Health Secretary Steve Barclay insisted "there is room" for discussion with the nursing union, but appeared to rule out moving on pay.
He visited Chelsea and Westminster Hospital in London - a Trust where nurses are not on strike. Downing Street insisted “I don’t think you can say he has been ducking a meeting with them” after he previously met Ms Cullen but refused to discuss pay.
Pamela Jones, on the picket line outside Aintree University Hospital in Liverpool, said: "I'm striking today because I've been nursing for 32 years.
“Within those 32 years the changes have been astronomical.
"I feel really sorry for the young girls who are now trying to get into the profession, they have to pay for their training.
"The public need to understand the pressures that everyone's under. You've only got to come into A and E and see the queues, there's no beds.
"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 Cullen insisted: “I'm having no row with anyone.
“What I'm asking this government to do is please listen to the voice of nursing. And if you listen to the voice of nursing, you listen to the voice of patients.”
She said Health Secretary Steve Barclay “has brought me into meetings and talked about anything else but nurses' pay.”
She added: “The bitter end means that we need to stand up for our health service.
“We need to find a way of addressing those over 7million people that are sitting on waiting lists.
“And how are we going to do that - by making sure that we've got the nurses to look after our patients, not with 50,000 vacant posts and it increasing day by day, and at the same time just draining our nurses out of the health service.
“We can't keep on doing this.”
Health minister Maria Caulfield said around 70,000 appointments, procedures and surgeries will be lost in England due to the strike. Thousands more will be affected in Northern Ireland and Wales.
She told Sky News: "Cancer surgeries are going to be closed in those 44 trusts in England. We reckon it's about 70,000 appointments, procedures, surgeries that will be lost."
The health service will be running a bank holiday-style service in many areas, though 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.
Picket lines have been set up at dozens of hospitals. Major trusts taking part include Guy's and St Thomas NHS Foundation Trust in London, Addenbrookes Hospital in Cambridge and University Hospitals Birmingham NHS Foundation Trust.
Saffron Cordery, interim chief executive of NHS Providers, told the PA news agency NHS trusts were "pulling out all the stops" to lessen the impact on patients.
She added: "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."
