Thousands of nurses in Wales are staging a second walkout in less than a week on Tuesday in a row over pay after nurses in Wales voted for industrial action in November for the first time in history. . All but one health board in Wales are involved.
More action is expected on Wednesday with ambulance staff in England and Wales set to walk out too, unless a meeting later with the UK health secretary Steve Barclay can avert it.
Last week, there was significant disruption in hospitals on Thursday as nurses went on strike for the first time in NHS history. Thousands of unionised nursing staff from the Royal College of Nursing (RCN) walked out.
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Aneurin Bevan University Health Board members voted to strike but did not reach the 50% turnout threshold needed for industrial action. You can see how the strike went last week here.
Staff say the dispute centres on pay and patient safety with the RCN claiming the number of vacancies in NHS Wales is now at an unprecedented 3,000. It has asked for 5% above the RPI rate of inflation which stands at over 12%, but Welsh Government claims it cannot afford to increase pay without help from the UK government.
The Royal College of Nursing (RCN) and the Government are also locked in a bitter dispute over pay, with ministers saying the salary rise demanded by unions is unaffordable.
On Wednesday, ambulance workers including paramedics, control room workers and technicians will also walk out in England and Wales, with health chiefs warning this represents the most serious threat to date.
The Government has implemented the recommendations of the independent pay review body, which gave nurses a rise of about 4.75%, with a guaranteed minimum of £1,400.
During Tuesday's strike, the NHS will be running a bank holiday-style service in many areas as thousands of operations and procedures are cancelled and rescheduled.
The RCN has said it will still staff chemotherapy, emergency cancer services, dialysis, critical care units, neonatal and paediatric intensive care, as well as some other services.
Speaking ahead of the strike, RCN chief executive Pat Cullen said: "The Prime Minister should ask himself what is motivating nursing staff to stand outside their hospitals for a second day so close to Christmas.
"They are prepared to sacrifice a day's pay to have their concerns heard. Their determination stems as much from worries over patient safety and the future of the NHS than personal hardship.
"Rishi Sunak is under growing pressure in Westminster following last Thursday's strike and he should listen to people around him.
"The public is increasingly with their local nursing staff and this Government desperately needs to get on the right side of them. It is unprecedented for my members to strike.
"Let's get this wrapped up by Christmas. I will negotiate with him at any point to stop nursing staff and patients going into the new year facing such uncertainty.
"But if this Government isn't prepared to do the right thing, we'll have no choice but to continue in January and that will be deeply regrettable."
UK Health Secretary Steve Barclay said: "The RCN's demands are unaffordable during these challenging times and would take money away from frontline services while they are still recovering from the impact of the pandemic. I'm open to engaging with the unions on how to make the NHS a better place to work."
Mr Barclay will meet unions representing striking ambulance drivers in 11th hour talks on Tuesday, although the discussions are unlikely to avert the action.
He wants to discuss patient safety with Unison, GMB and Unite but his refusal to negotiate on pay means the following day's strikes are bound to go ahead.
The Health Secretary is understood to hold concerns over whether all emergency calls will be covered, but unions said there would be "no strikes at all if ministers would only talk to unions and improve NHS pay".
Prime Minister Rishi Sunak told reporters on Monday the Government had adopted a "fair and responsible approach to pay".
He stressed the need to "combat inflation" which is "making everybody in the UK's life difficult", adding: "Part of us doing that is having a responsible and fair approach to pay.
"I'm really disappointed to see that the unions are calling these strikes, particularly at Christmas, particularly when it has such an impact on people's day-to-day lives with the disruption it causes and the impact on their health.
"I would urge them to keep considering whether these strikes are really necessary and do everything they can to alleviate the impact it's going to have on people."
The Government has announced controversial plans to deploy more than 1,000 civil servants and 1,200 troops to cover for striking ambulance workers and Border Force staff, who are preparing to walk out for eight days from December 23 until New Year's Eve.
Unions have branded the move a "desperate measure", warning the servicemen and women are not "sufficiently trained" to plug staffing gaps on the front line, while the Chief of the Defence Staff has said the armed forces should not be treated as "spare capacity".
During Wednesday's ambulance strike, the military will not drive ambulances on blue lights for the most serious calls but are expected to provide support on less serious calls.
Negotiations between unions and ambulance services are still ongoing to work out which incidents should be exempt from strike action.
All category 1 calls (the most life-threatening such as cardiac arrest) will be responded to, while some ambulance trusts have agreed exemptions with unions for specific incidents within category 2 (serious conditions, such as stroke or chest pain).
This means those who suffer trips, falls or other non-life-threatening injuries may not receive treatment.
Members of the GMB are set to stage a second ambulance worker walkout on December 28.
Meanwhile, rail workers are preparing to continue their strikes, with a walkout planned for Christmas Eve.
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