Nurses will start striking for longer, at more places and will disrupt more NHS services from next month unless the government increases its pay offer, hospital bosses have said.
Tens of thousands of outpatient appointments and non-urgent operations were cancelled on Thursday as nurses across England, Wales and Northern Ireland went on strike over pay.
A second 12-hour stoppage is due next Tuesday at dozens of hospitals, mental health units and specialist care providers such as children’s hospitals.
NHS Employers, which represents all health trusts in England on staff’s terms and conditions, has told its members that the Royal College of Nursing (RCN) is likely to expand and intensify its planned campaign of strikes unless ministers agree to negotiate a new pay deal.
The RCN called members out on strike on Thursday at only half the number of trusts at which a majority of nurses in its recent UK-wide strike ballot voted to stop work.
Danny Mortimer, the NHS Employers chief executive, wrote to trusts on Wednesday after holding discussions with the RCN about the dispute. He reminded them that the RCN’s decision not to hit all of the care providers it could have done only applied to Thursday and next Tuesday’s action.
“Unless the government indicates a willingness to negotiate on pay-related matters, further strike dates will be announced by the RCN for January 2023 and beyond. It is likely that these strikes will be for a longer time period on each occasion and will cover a greater number of organisations [NHS trusts] in England,” he said. “It is also likely that the position reached yesterday on derogations will be altered and reduced further. Reballoting is also likely.”
Derogations are exemptions from strike action that the RCN agrees to put in place to ensure that services involving the provision of potentially life-preserving care can go ahead. It agreed to expand the list of exemptions for Thursday and next Tuesday after pressure from NHS chiefs.
Mortimer’s intervention adds to the growing pressure on Rishi Sunak and the health secretary, Steve Barclay, to drop their refusal to engage in detailed discussions with the RCN about nurses’ pay. Both have insisted they cannot increase their offer of a £1,400 rise for most NHS staff this year because they are bound by the advice of the NHS pay review body.
Ruth May, England’s chief nursing officer and a senior figure at NHS England, made clear on Thursday that she wanted ministers to urgently strike a deal with the RCN to end the strikes.
Eleanor Hayward, the health correspondent of the Times, tweeted a photo of May at the RCN picketline outside St Thomas’ hospital in London, and wrote: “She [May] says she supports striking nurses and ministers must reach an ‘urgent resolution’ with the nursing union over pay.”
There is growing unease among Conservative MPs at Barclay’s refusal to talk about revising the £1,400-a-head figure. Steve Brine, a former health minister who now chairs the Commons health select committee, said on Monday that in light of the RCN’s offer to postpone strikes if Barclay agreed to discuss pay, the health secretary’s stance meant it was “1-0 to the RCN” in the battle for public sympathy.
On Thursday two other Tory former ministers – Jake Berry, until recently the Tory party chairman, and Dr Dan Poulter, a former health minister who is also an NHS doctor – urged Barclay to rethink. Poulter said the RCN’s demand for a rise of 5% above inflation was “unrealistic”, but he said the government should “improve on the current offer on the table for nurses” because there was a “good economic case” for doing so.
He said: “Suppressing pay well below the rate of inflation will encourage more NHS staff to do less contracted hours and either work as expensive agency or locum staff or to leave the NHS to work elsewhere – perhaps for private healthcare providers, both of which cost the NHS money.”
Meanwhile, a senior NHS leader has said the ambulance strike that is due to take place next Wednesday poses a much more direct threat to patients’ safety than Thursday’s action by nurses.
Sir Jim Mackey, NHS England’s director of elective recovery, told an event at the King’s Fund health thinktank: ‘The ambulance strike is a completely different order of magnitude of risk [then the nurses’ strike]. I think that’s the main thing people are worried about, because of the complexity and fragility of urgent care.”
The remarks by Mackey, who is also the chief executive of the Northumbria Healthcare NHS foundation trust, reflect the acute concern among senior NHS figures that patients could die as a direct result of ambulance workers withdrawing their labour next Wednesday.
Members of Unison, Unite and the GMB unions working in ambulance services in England and Wales are due to take part in the stoppage.
Downing Street said on Thursday that proposed legislation to limit strike action on public transport has been “paused” while ministers consider broadening its scope. There have been suggestions that the transport strikes (minimum service levels) bill could be widened to include emergency service workers.
The prime minister’s official spokesperson said: “Essentially, we’ve paused that bill and are looking at adding additional measures to it to widen its scope. We haven’t set out exactly the scope of what we would be bringing forward as part of these new powers but we will do so as soon as possible.”
