Real concerns remain about the level of cover nurses will provide for cancer patients during Thursday’s strike, the head of NHS Employers has said.
In a letter to NHS leaders, Danny Mortimer said some aspects of talks with the Royal College of Nursing (RCN) had been disappointing and warned that “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”.
The letter, dated Wednesday December 14 and seen by the PA news agency, said: “To be clear – real concerns remain.
“There are areas where we are disappointed that we have not been able to make more progress with the RCN, with the limited national derogations for cancer services a particular area of worry.”
An RCN spokesman said: “Scaremongering helps nobody.
“As part of our commitment to safety and patient care, we have already agreed that emergency cancer surgery goes ahead and so should other clinically urgent cases.
“Mr Mortimer and colleagues can continue to raise their concerns constructively and continue to reach agreement.”
On future strikes, Mr Mortimer said in his letter that unless the Government moved on pay, “it is likely that these strikes will be for a longer time period on each occasion and will cover a greater number of organisations in England”.
“It is also likely that the position reached yesterday on derogations will be altered and reduced further. Re-balloting is also likely,” he added.
Derogations relates to the areas of care that nurses agree they will cover during a strike.
The 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.
But there have been concerns from within the NHS over what level of cover trusts can expect for urgent cancer treatment.
The RCN has committed to emergency cover but the NHS had asked for the protection of urgent services as well.
In his letter, Mr Mortimer said other unions representing health workers will also announce further dates for strike action.
“While there may not necessarily be complete co-ordination between trade unions, the impact on services, patients and staff continues to be a source of real concern for you,” he said.
“There seems still to be limited ability for the Government to agree to substantive talks with trade unions.
“I know that this situation is starting to place a strain on broader local, regional and national partnerships.”
The letter also said the RCN had told NHS Employers that some nurses had been subject to conversations about prosecution and regulatory referrals.
Mr Mortimer said it was “highly unlikely” that a section of the law where the consequence of breaking a contract is to endanger human life or cause serious bodily injury was applicable to this strike.
RCN chief executive, Pat Cullen, has accused Health Secretary, Steve Barclay, of “belligerence” after he refused to discuss the issue of pay.
He has repeatedly said the Government is sticking to the recommendations of the independent pay review body, which recommended nurses get a pay rise of around £1,400.
The RCN has been calling for a pay rise at 5% above inflation, though it has indicated it would accept a lower offer.
When it submitted the 5% figure to the independent pay review body in March, inflation was running at 7.5%. But inflation has since soared, with RPI standing at 14.2% in September.
Earlier on Wednesday, Labour leader Keir Starmer accused the Prime Minister of entering “hibernation” rather than working to get Thursday’s strike called off.
At Prime Minister’s Questions, Sir Keir said that all Mr Sunak needs to do to avert the strikes is to “open the door and discuss pay with them”.
“If he did, the whole country would breathe a sigh of relief. Why won’t he?” the Labour leader asked.
Mr Sunak insisted his Government has “consistently spoken to all the unions involved in all the pay disputes” and said it was standing by the independent pay review body recommendations.