Hospitals will "minimise patient harm" if nurses go on strike, an NHS leader said.
NHS Confederation chief executive Matthew Taylor told BBC breakfast plans are in place to treat patients should a strike go ahead. But operations and appointments will be cancelled or postponed if nurses walk out.
He said: “Clearly industrial action is a challenge for the health service and NHS leaders.
Read more: Nurses at North East hospitals and the ambulance service set for strike action
“We’re already coping with the gap that exists between the demand that is currently on the health service from the public. We’ve got to meet that demand, and we all know that we are heading into what already is a very difficult winter.
“Then we add industrial action into that and it’s going to be an extremely difficult job. The priority will be to try to minimise patient harm.”
Nursing staff at the four of the North East's acute NHS hospital trusts - Northumbria Healthcare, Newcastle Hospitals, Gateshead Health and County Durham and Darlington voted in favour of action as did colleagues at the North East Ambulance Services NHS Trust
The Royal College of Nursing (RCN) has promised to maintain emergency and critical care, but Mr Taylor warned “there will be an impact if there is industrial action in terms of cancelled appointments, cancelled procedures, and NHS leaders will do everything we can to minimise that and to ensure that patients are kept informed of what is happening.”
Speaking about nursing, Mr Taylor said he is aware that striking is rare and a "last resort" for nurses, adding that the dispute is about more than money.
“It’s important to understand that, whenever you speak to nurses, they will say pay is part of the challenge but it’s also about workload, about the fact that there are nearly 50,000 nurse vacancies across the NHS.
“Even if there wasn’t any industrial action, we would still have a really big issue about how we recruit, how we retain and how we motivate staff in the NHS.”
The health leader said workers have been “waiting for a very long time” for a properly-costed workforce strategy from the Government.
There have also been “briefings in recent days that there will be a pay freeze or pay cap on the public sector next year – that kind of background is not helpful to these talks”.
Patricia Marquis, RCN director for England, told BBC Breakfast that current NHS services were “not safe” and the Government has “failed to listen” to what nursing staff have been saying.
She said there are some services that need to continue during strike action to keep patients safe “and we will agree with employers what those are and which staff should be working”.
She added that employers across most of the UK needed 14 days’ notice of strike action, adding: “What I can say is that we intend to take action certainly before the end of this year.”
The RCN announced on Wednesday that its members in the majority of NHS employers across the UK have backed industrial action.
During industrial action the health service will turn its attention to treating emergency patients in a “life-preserving care model”, with sources saying some hospitals on strike days will have staffing levels similar to those over Christmas.
Some of the most serious cancer cases could still be treated, while urgent diagnostic procedures and assessments will be staffed if they are needed to gather data on potentially life-threatening conditions or those that could lead to permanent disability.
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