By Emily Craig Health Reporter For Mailonline and Sophie Huskisson Health Reporter For The Daily Mail
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Soldiers could be drafted in to drive ambulances this winter if paramedics join the devastating wave of NHS-wide strikes, it was claimed today.
An official tasked with preparing the ailing health service for the months of chaos ahead revealed that ‘use of the Army is on the list of potential contingencies’. The British Red Cross and St John Ambulance may also be called upon.
Military personnel were drafted in throughout the pandemic to support struggling ambulance trusts, with them asked to drive vehicles and provide basic life support on some 999 calls.
Paramedics and emergency medical technicians, more junior ambulance crew members, are among the close to one million NHS workers either being balloted or expected to be in the coming weeks.
One union orchestrating action, the Royal College of Nursing (RCN), has already announced historic walk-outs will happen. Dozens of hospitals will be affected, with a ‘bank holiday service’ threatening to pile further misery on an already-crippled NHS.
Crisis talks between the Government and the ‘militant’ nursing union were held today amid warnings that strikes could rumble on for six months.
Health Secretary Steve Barclay met Pat Cullen, the boss of the 106-year-old RCN, in the hope of thrashing out a last-ditch deal to avert historic industrial action.
A senior Department of Health and Social Care source told the Daily Mail the meeting between Mr Barclay and Ms Cullen lasted about an hour long in the Health Secretary’s Office in the Department of Health.
ENGLAND
EAST MIDLANDS
East Midlands Ambulance Service NHS Trust
NHS Derby and Derbyshire ICB (Joined Up Care Derbyshire)
NHS Nottingham and Nottinghamshire ICB
Derbyshire Healthcare NHS Foundation Trust
Northamptonshire Healthcare NHS Foundation Trust
Derbyshire Community Health Services NHS Foundation Trust
Nottinghamshire Healthcare NHS Foundation Trust
Nottingham University Hospitals NHS Trust
Kettering General Hospital NHS Foundation Trust
EAST OF ENGLAND
Cambridgeshire and Peterborough NHS Foundation Trust
Norfolk and Norwich University Hospitals NHS Foundation Trust
Cambridge University Hospital NHS Foundation Trust
Royal Papworth Hospital NHS Foundation Trust
East Suffolk and North Essex NHS Foundation Trust
Norfolk Community Health and Care NHS Trust
Norfolk and Suffolk NHS Foundation Trust
Cambridgeshire Community Services NHS Trust
Hertfordshire Community NHS Trust
West Suffolk NHS Foundation Trust
NHS Hertfordshire and West Essex ICB
NHS Mid and South Essex ICB
NHS Norfolk and Waveney ICB
NHS Suffolk and North East Essex ICB
LONDON
Imperial College Healthcare NHS Trust
Guys and St Thomas NHS Foundation Trust
Great Ormond Street Hospital for Children NHS Foundation Trust
Hounslow and Richmond Community Healthcare NHS Trust
St George’s University Hospitals NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Royal Marsden NHS Foundation Trust
Tavistock and Portman NHS Foundation Trust
University College London Hospitals NHS Foundation Trust
NHS North Central London ICB
NHS South West London ICB
NHS Resolution
NORTH WEST
Mersey Care NHS Foundation Trust
Tameside and Glossop Integrated Care NHS Foundation Trust
Liverpool Heart and Chest Hospital NHS Found Trust
Lancashire Teaching Hospitals NHS Foundation Trust
The Clatterbridge Cancer Centre NHS Found Trust
The Christie NHS Foundation Trust
Wrightington Wigan and Leigh NHS Foundation Trust
Countess of Chester Hospital NHS Foundation Trust
North West Ambulance Service NHS Trust
Liverpool University Hospitals NHS Foundation Trust
Mid Cheshire Hospitals NHS Foundation Trust
Bridgewater Community Healthcare NHS Foundation Trust
Wirral Community Health and Care NHS Foundation Trust
Midlands and Lancashire CSU
Wirral University Teaching Hospital NHS Found Trust
Liverpool Women’s NHS Foundation Trust
Central Cheshire Integrated Care Partnership
St Helens and Knowsley Teaching Hospitals NHS Trust
Alder Hey Children’s NHS Foundation Trust
The Walton Centre NHS Foundation Trust
Health Education England
NHS Cheshire and Merseyside ICB
NHS Lancashire and South Cumbria ICB
Cheshire and Wirral Partnership NHS Foundation Trust
NORTHERN
North East Ambulance Service NHS Trust
University Hospitals of Morecambe Bay NHS Foundation Trust
Northumbria Healthcare NHS Foundation Trust
County Durham and Darlington NHS Foundation Trust
Gateshead Health NHS Foundation Trust
The Newcastle Upon Tyne Hospitals NHS Foundation Trust
South Tees Hospitals NHS Foundation Trust
North of England CSU (NECS)
SOUTH EAST
Kent Community Health NHS Foundation Trust
East Sussex Healthcare NHS Trust
University Hospitals Sussex NHS Foundation Trust
South East Coast Ambulance Service
Sussex Community NHS Foundation Trust
Sussex Partnership NHS Foundation Trust
Queen Victoria Hospital NHS Foundation Trust
NHS Kent and Medway ICB
NHS Surrey Heartlands ICB
Southern Health NHS Foundation Trust
Oxford University Hospitals NHS Foundation Trust
Portsmouth Hospitals NHS Trust
University Hospital Southampton NHS Foundation Trust
South Central Ambulance Service NHS Foundation Trust
Solent NHS Trust
Royal Berkshire NHS Foundation Trust
Oxford Health NHS Foundation Trust
SOUTH WEST
Cornwall Partnership NHS Foundation Trust
Devon Partnership NHS Trust
South Western Ambulance Service NHS Found Trust
SOUTH WEST (CONTINUED)
Dorset Healthcare University NHS Foundation Trust
Gloucestershire Hospitals NHS Foundation Trust
North Bristol NHS Trust
Torbay and South Devon NHS Foundation Trust
University Hospitals Plymouth NHS Trust
University Hospitals Bristol and Weston NHS Foundation Trust
Dorset County Hospital NHS Foundation Trust
NHS Blood and Transplant (NHSBT)
Gloucestershire Health and Care NHS Foundation Trust
Royal Devon University Healthcare NHS Foundation Trust
Avon and Wiltshire Mental Health Partnership NHS Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
University Hospitals Dorset NHS Foundation Trust
Somerset NHS Foundation Trust
Royal Cornwall Hospitals NHS Trust
Royal United Hospitals Bath NHS Foundation Trust
NHS Bath, North East Somerset, Swindon and Wiltshire ICB (BSW Together)
NHS Devon ICB (One Devon)
NHS Dorset ICB (Our Dorset)
NHS Gloucestershire ICB (One Gloucestershire)
WEST MIDLANDS
Midlands Partnership NHS Foundation Trust
Herefordshire and Worcestershire Health and Care NHS Trust
The Royal Orthopaedic Hospital NHS Foundation Trust
Worcestershire Acute Hospitals NHS Trust
Shropshire Community Health NHS Trust
University Hospitals Birmingham NHS Foundation Trust
Birmingham Women’s and Children’s NHS Foundation Trust
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Dudley Integrated Health and Care NHS Trust
NHS Birmingham and Solihull ICB (BSol ICB)
NHS Black Country ICB
YORKSHIRE AND THE HUMBER
Sheffield Health and Social Care NHS Foundation Trust
Barnsley Hospital NHS Foundation Trust
York and Scarborough Teaching Hospitals NHS Foundation Trust
Leeds Community Healthcare NHS Trust
Bradford Teaching Hospitals NHS Foundation Trust
Harrogate and District NHS Foundation Trust
The Leeds Teaching Hospitals NHS Trust
NHS England
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield Children’s NHS Foundation Trust
NHS West Yorkshire ICB
WALES
Cardiff and Vale University Health Board
Powys Teaching Local Health Board
Welsh Ambulance Services NHS Trust Headquarters
Hywel Dda University Health Board
Swansea Bay University Health Board
Cwm Taf Morgannwg University Health Board
Betsi Cadwaladr University Local Health Board
Velindre NHS Trust
Public Health Wales
Health Education and Improvement Wales Health Authority
NHS Wales Shared Services Partnership
Digital Health and Care Wales
SCOTLAND
NHS Borders
NHS Education For Scotland
NHS Fife
NHS National Services Scotland
NHS Shetland
NHS Western Isles
NHS Dumfries and Galloway
NHS Orkney
NHS Golden Jubilee
NHS 24
The State Hospitals Board for Scotland
NHS Grampian
NHS Tayside
NHS Ayrshire and Arran
The Highland Council
Healthcare Improvement Scotland
Public Health Scotland
NHS Greater Glasgow and Clyde
Scottish Ambulance Service
NHS Lothian
NHS Lanarkshire
NHS Highland
NHS Forth Valley
NORTHERN IRELAND
Northern Ireland Practice and Education Council
Southern Health and Social Care Trust
Western Health and Social Care Trust
Belfast Health and Social Care Trust
Business Services Organisation
Regulation & Quality Improvement Authority
Northern Ireland Blood Transfusion Service
Public Health Agency
Northern Health and Social Care Trust
South Eastern Health and Social Care Trust
Northern Ireland Ambulance Service
‘They covered a range of issues, both about pay but also on non-pay issues, especially about patient safety,’ they said.
‘They agreed that they’re going to meet again shortly.
‘Pay is a difficult issue. We are taking the recommendation from the independent review body. They spoke about a range of issues on both sides and Steve explained the difficult situation we are facing at the moment.
‘Steve has said his door is always open. He values the work of nurses and wants to engage with them about the concerns they have. He is definitely in listening mode.’
Mr Barclay himself described the meeting as ‘constructive’, insisting that his priority ‘is to keep patients safe and minimise disruption’.
The RCN said: ‘Today’s meeting with Steve Barclay was a cordial introduction that covered many important, broad topics.
‘We await a future meeting to address the specifics of our dispute and the reality that our members have voted to strike.’
Nurses are fighting for an inflation-busting pay rise of around 17 per cent, the equivalent of around £6,000 for an average nurse who earns £35,000.
Ministers have refused to meet the RCN’s demand, warning it would effectively cost the taxpayer £9billion, which ‘in the current climate is simply not deliverable’. Mr Barclay said the union was ‘out of step’ with the UK’s economic situation and the request was not ‘reasonable or affordable’.
Close to 20,000 ambulance workers, including call handlers, are currently being balloted by GMB and Unison.
If they follow the RCN’s lead, it could be the biggest ambulance strike in three decades.
One NHS source told the Guardian: ‘The biggest challenge will be if ambulance service staff vote to strike. Strikes by ambulance staff are such a worry mainly because of how much pressure they are under and how services could reasonably be expected to maintain a high level service with so many paramedics off.
‘It’s not like other services where you can, to an extent, ration services, for example by not doing elective surgery [in order] to put more staff into emergency care.’
Industrial action is expected to begin before Christmas, with reports it will take place over two dates, potentially a Tuesday and a Thursday
This graph shows the Royal College of Nursing’s demands for a 5 per cent above inflation pay rise for the bands covered by its membership which includes healthcare assistants and nurses. Estimates based on NHS Employers data
The graph shows the current average salary of public sector workers (blue bars) and how much more their unions are asking their pay to be increased by (yellow bars). The nurses’ union is asking for a salary increase of five per cent on top of RPI inflection, which current sits at 12.6 per cent
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The RCN is just one NHS union which has or is balloting its members over pay
An official added: ‘Use of the army is on the list of potential contingencies [to help the NHS]. It’s in the “not unrealistic” scenario.’
Results of the GMB and Unison ballots aren’t due until the end of November.
It comes as official figures today revealed that ambulances were slower than ever at responding to 999 calls last month.
The average category one response time — calls from people with life-threatening illnesses or injuries — was nine minutes and 56 seconds. The target time is seven minutes.
Ambulances took an average of 1 hour, one minute and 19 seconds to respond to category two calls, such as burns, epilepsy and strokes – three times’ longer than the 18-minute target.
More than 100 soldiers were brought in to drive ambulances in Scotland last autumn. A similar number of troops were deployed in Wales to work as ambulance drivers.
Military personnel were also used to support ambulance services in the South Central, South West, North East, North West and East regions of England.
Health Secretary Steve Barclay (left, today ahead of his meeting) has been accused of being the invisible man due to his lack of action on a looming NHS nurses strikes. Breaking his silence last night, he said: ‘We are all hugely grateful for the hard work and dedication of NHS staff, including nurses, and deeply regret that some union members have voted for industrial action’. Pat Cullen (right, leaving the Department of Health offices), RCN General Secretary
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What was the result of the strike?
Nurses at the majority of NHS organisations on the ballot voted to strike – 176 out of 311 NHS employers across the UK. Some did not meet the 50 per cent turnout threshold.
When will strikes last and how long will the strike last?
Strikes are expected to begin in early December and could take place over two dates, potentially a Tuesday and a Thursday. They could last until early May 2023.
What level of care can patients expect?
The RCN handbook says nursing provision during the strike period should be equal to the skeleton staffing usually seen on Christmas Day, although the NHS says it has well-tested procedures to limit disruption.
Which nurses will remain in post?
Emergency nurses in A&E and intensive care will keep working, as will district nurses who help elderly people in the community. Other exemptions will be negotiated at a local level.
Why are nurses going on strike?
The Royal College of Nursing is campaigning for a pay rise of five per cent above inflation, claiming an experienced nurse’s salary has fallen by 20 per cent since 2010.
What is the pay deal they are unhappy with?
Nurses in England and Wales received a pay increase of at least £1,400 this year, but the RCN claims this left them effectively working a day a week for free.
Have there been nursing strikes before?
Yes – some nurses from the union UNISON went on strike in 2014 and RCN nurses in Northern Ireland walked out in 2019 but this is the first time the RCN has balloted all its 300,000 members in all UK countries in its 106-year history.
Who could be next to strike?
Hundreds of thousands of junior doctors, midwives, physiotherapists, paramedics, ICT staff and porters are among NHS staff either being balloted or expected to be balloted on strike action over anger about pay rises. The next result should be from Unison, who closes its ballot on November 25 after asking 350,000 NHS workers whether they want to strike.
SCROLL DOWN FOR OUR FULL Q&A, OR READ IT HERE.
It comes as Mr Barclay faced pressure to avert strikes in the NHS this winter.
Ahead of his meeting with the RCN’s boss, Whitehall sources said Mr Barclay was ‘not negotiating’ on pay and that he was only going to discuss how nurses’ working conditions can be improved this winter.
Mr Barclay tweeted this afternoon: ‘Constructive meeting with the RCN covering a number of topics.
‘Nurses do an incredible job & I regret some union members have voted for strikes. My priority is to keep patients safe and minimise disruption – my door is open & we have agreed to meet again shortly.’
The RCN said: ‘Today’s meeting with Steve Barclay was a cordial introduction that covered many important, broad topics. We await a future meeting to address the specifics of our dispute and the reality that our members have voted to strike.’
The union has warned that strikes will kick-off before Christmas and run sporadically until May — spanning around six months.
Emergency care won’t be disrupted by the walk-outs, yet health insiders fear lives will still be lost as a result of the action.
A senior NHS boss today insisted hospitals will do all they can to ‘minimise harm’ to patients but admitted ops and appointments will inevitably be cancelled or postponed, worsening the backlog that sits at an all-time high of 7.1m in England alone.
Specialist cancer hospitals, including London’s Royal Marsden and the Clatterbridge Cancer Centre in Liverpool, voted for action, putting chemotherapy appointments at risk. Care at maternity hospitals and specialist children’s hospitals will also be disrupted, while nurses will also strike at the biggest hospitals in London, including Guy’s and St Thomas’, opposite the House of Commons.
Tories have labelled the action ‘criminal’ and warned that lives will be lost as a result of the action. One MP told the Mail: ‘It’s not a job you choose if hoarding wealth is what you’re looking for.’
Ms Cullen, general secretary of the RCN — a union that has been described as ‘militant’, said: ‘We don’t intend to place any patient at further risk during the strike.
‘We will manage that safely and effectively.’
In total, 176 NHS organisations across the UK voted in favour of strikes, out of a total of 311 employers included in the ballot. Some did not meet the 50 per cent turnout threshold.
The fact that not all trusts will strike is expected to exacerbate a postcode lottery of care, with different areas of the country to suffer vast disparities in waiting times for appointments, treatment and ambulance responses.
Critical care in life threatening situations should not be put at risk if strikes take place, however elective treatment, outpatient care and other healthcare services, including chemotherapy, dialysis and surgery, are likely to be impacted.
In addition to nurses, approximately one million NHS staff members, including junior doctors, midwives, ICT staff and porters, are either being balloted or are expected to be balloted on strike action over anger about pay rises.
Education Secretary Gillian Keegan this morning suggested most nurses forced to use foodbanks are being driven to do so by a broken ‘relationship or boiler’ on Sky News. The former Minister for Care and Mental Health has previously been criticised for sporting a £10,000 Rolex watch
Matthew Taylor, chief executive of the NHS Confederation, which represents most NHS organisations, told BBC Breakfast there are national and regional plans to minimise the impact on patients, but admitted operations and appointments will have to be cancelled or postponed
MPs have warned workers to ‘think very carefully’ over strike action and pay demands that ‘would just break the NHS completely’.
Health insiders said if the strikes went ahead, it could see hospitals fall into disrepair and patients’ calls go unanswered. One source added: ‘The impact of coordinated strikes will be that death rates will rise.’
Tory MP Mark Jenkinson said: ‘Nurses do a wonderful job and are under tremendous pressure but it’s not a job you choose if hoarding wealth is what you’re looking for.
‘You don’t choose a job like that if caring isn’t the centre of your thinking. Ultimately the people who will be hurt the most are the patients.’
Matthew Taylor, chief executive of the NHS Confederation, which represents most health service organisations, told BBC Breakfast today there are national and regional plans to minimise the impact on patients.
But he admitted operations and appointments will have to be cancelled or postponed.
He said: ‘Clearly industrial action is a challenge for the health service and NHS leaders.
Official figures show 7.1million people in England were in the queue for routine hospital treatment, such as hip and knee operations, by the end of September — the equivalent of one in eight people (red line). The figure includes more than 400,000 people who have been waiting, often in pain, for over one year (yellow bars)
Meanwhile, emergency care performance has deteriorated to fresh lows. More than 1,400 A&E attendees were forced to wait in more than 12 hours for care every day in October (yellow bars), while the lowest proportion ever recorded were seen within four hours — the NHS target (red line)
Ambulance performance statistics for October show paramedics took longer to arrive to category one, two and three call outs since records began in 2017. Ambulances took an average of 1 hour, one minute and 19 seconds to respond to category two calls (red bars), such as burns, epilepsy and strokes. This is more than three times as long as the 18 minute target
Cancer care plummeted in September. Just 60.5 per cent of patients started cancer treatment within two months of being referred for chemotherapy or radiotherapy (red line). The figure is down from 61.9 per cent one month earlier and is the lowest ever recorded in records going back to October 2009. The NHS states 85 patients should start treatment within this timeframe
The latest NHS data recorded that about 45,000 nursing posts in England are vacant as of the end of June. London has highest percentage missing, with 15 per cent of nursing posts unfilled
NHS data shows efforts to get more nurses into the health service are only barely keeping pace with the number of experienced nurses quitting
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NHS waiting lists have sky-rocketed to a new record high amid warnings that the health service is already at ‘breaking point’ before winter pressures have even kicked-in.
Official figures show 7.1million people in England were in the queue for routine hospital treatment, such as hip and knee operations, by the end of September — the equivalent of one in eight people.
The figure includes more than 400,000 people who have been waiting, often in pain, for over one year.
The figures reflect the situation before winter pressures, such as an expected rise in Covid and flu admissions, have been felt in hospitals.
And it comes ahead of industrial action by NHS nurses, which is expected to see thousands of operations and treatments cancelled as the NHS is reduced to a ‘bank holiday’ service on strike days.
Meanwhile, emergency care performance has deteriorated to fresh lows.
More than 1,400 A&E attendees were forced to wait in more than 12 hours for care every day in October, while the lowest proportion ever recorded were seen within four hours — the NHS target. The situation is thought to be even worse than the official data suggests.
And cancer care approached its worst-ever performance in September, with just six in 10 newly-diagnosed patients starting treatment within two months.
Top oncologists warned there is a ‘real and frightening possibility’ that Government won’t provide sufficient investment needed to catch-up and more lives will be lost.
The NHS bragged that it has cut the number of patients who have been queuing for hospital treatment for 18 months, while dealing with a rise in Covid and flu patients, as well as emergency care pressures.
‘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.’
He noted that the RCN has promised to maintain emergency and critical care ‘but 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’.
He said workers take industrial action as a last resort — and that the action is about pay, workload and ‘the fact that there are nearly 50,000 nurse vacancies across the NHS’.
Mr Taylor said: ‘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 nursing staff.
She said most employers need 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.’
Saffron Cordery, interim chief executive of NHS Providers, urged ministers to talk to the unions to reach a resolution. ‘We have to see the Government come round the table,’ she said.
A senior health insider told the Daily Mail that lives will be lost due to the strikes, emphasising that ‘nurses are going to withdraw for non-urgent care but crucial care’.
They said: ‘Everything from routine blood tests, mammograms, smear tests, colonoscopies, skin biopsies, X-rays will come to a halt if routine treatment is cancelled. They’re all considered as non-emergency but everything is crucial when it comes to healthcare, including preventative action.
‘Many of these are often investigations for more sinister symptoms and conditions such as cancer. Instead of getting care, patients will see if their symptoms have gone away and turn to complementary treatment, such as taking pain killers, or a massage, or getting acupuncture, going to see an osteopath when really they need an MRI scan.
‘The impact of coordinated strikes will be that death rates will rise.
‘There will be a knock-on-effect, with a lag on the damage that will be done. The strikes are intended to impede the system but anything that impedes the system will impede patients too.’
And while some staff might be brought in to help with routine treatment, they emphasised that nurses are irreplaceable: ‘Non-qualified staff are not trained for problems such as spotting when a temperature is rising, or when a patient is dehydrated, or when someone needs screening for sepsis. They did it in the pandemic and it was a disaster.’
Dr Martin Scurr, a GP with more than 20 years experience, said: ‘It’s the nurses and the doctors who signed up to put the patients first. To go against that tide, just because you want a pay cheque, it’s not right.
‘I know people have things they need to pay for, childcare and paying off loan medicines, but we need to do it honourably. But the pendulum swings, I never thought I’d be able to get a mortgage when I graduated, but it did happen in the end. We can’t do everything now.’
It comes as a nurse revealed that she is forced to eat patients’ leftovers while she is working because she cannot afford food in the hospital canteen or the groceries to make a packed lunch.
Esther, who did not share her last name or the hospital she works at, told The Mirror that it is not allowed and she has been reprimanded when caught – but continues to do so to avoid feeling lightheaded during her shift.
And the 36-year-old, who moved to the UK from Zimbabwe last September, said lots of her colleagues do the same. She voted in favour of strike action.
The mother-of-three said: ‘Yes, I go without meals. Lunch, sometimes breakfast. You can’t go and buy a hot meal at work, it costs £6-7.
‘Sometimes you have to grab extra sandwiches from the patients’ trollies. Of course people will tell you it’s against hospital policy. Some say it’s okay. Most of the time I do that.
‘Sometimes they reprimand you, but they have not reported me. It is common to take the leftover food, even the British nurses do this. ‘It’s only ever the leftovers, and it keeps you going.’
Nursing staff were balloted following NHS Agenda for Change pay announcements earlier this year, which left experienced nurses 20 per cent worse off in real-terms compared to ten years earlier, the RCN said.
The Fair Pay for Nursing campaign is calling for a pay rise of five per cent above inflation (measured by RPI).
Nurse strike Q&A: How much cash do they want? When will walk-outs happen? And how will patients be affected? All the big questions answered as Royal College of Nursing confirms ‘historic’ action
NHS nurses will walk off the job this winter, the Royal College of Nursing (RCN) has confirmed, as the union released the results of its historic strike action ballot.
The result means tens of thousands of NHS nurses, healthcare assistants and midwives will strike this winter over pay.
There are fears that the resulting drop in staffing levels will lead to thousands of diagnostic tests and elective operations being cancelled at a time of record care backlogs.
Strike action could also pile even more pressure on to the health service at its hardest time of year, as it battles winter pressures and expected waves of Covid and flu, triggering concerns admissions will rise and more staff will be off from work.
The RCN is arguing for an inflation-busting pay rise for its NHS nurses amid reports staff are being forced to use food banks or quitting the profession entirely due to the rising cost of living.
Here, MailOnline answers all of your key questions surrounding the strikes and what happens next.
What is the Royal College of Nursing?
The RCN is Britain’s largest nursing union. Its membership consists of both nurses of all specialties — from the general nurses working in NHS hospitals to specialists like mental health, cancer and paediatric nurses.
Its members also include some other health and care staff groups like midwives and healthcare assistants.
Why are members striking?
The RCN argues that its members working in the NHS are not paid enough and this contributing to staffing problems in the health service.
While this argument has been made for years, soaring inflation has exacerbated these concerns.
There have been reports of nurses struggling to pay their bills or leaving the profession for jobs in sectors like retail.
On October 6, the union launched a historic ballot asking 300,000 members working in the NHS across the UK if they would on taking strike action.
Ballots closed on November 2 and the results were revealed today.
What was the result?
In total, 178 NHS organisations are due to take strike action across the UK after meeting the legal thresholds for strike action.
This includes all of the NHS employers in Northern Ireland and Scotland and all bar one in Wales. In England, this includes 130 NHS organisations.
The types of NHS bodies impacted by strike action includes NHS trusts and health boards which manage hospitals, ambulance trusts, and Integrated Care Bodies which broadly manage NHS services in areas of England.
Of the total organisations that returned a valid strike ballot in England 50 of them are acute NHS trusts that provide hospital care and six out of 11 ambulance trusts.
What does the RCN want?
The union wants nurses to get a pay rise 5 per cent above inflation, which currently sits around 12 per cent.
This would grant the average nurse, who earns roughly £35,600 each year, an extra £6,000 annually.
This is far above the Government’s offer of about 4 per cent.
So what happens now?
The RCN is expected to unveil further details of the strike action in the weeks to come.
This will include which parts of the NHS will be affected by strike action on what days, as well as for how long.
Previous strike action by nurses in Northern Ireland in 2019/20 saw nurses walk off the jobs from almost all services minus those providing life saving care in 12-hour blocks.
I have an operation scheduled at my local NHS hospital in the next few months, could it be cancelled?
Possibly. Previous strikes by NHS staff have led to the cancellation on non-emergency procedures and appointments.
If your appointment is scheduled it could be canceled by strike action as it is probably not classified as emergency or urgent care.
If an individual appointment is cancelled or not will depend if the date falls on a strike action day and is one of those where nurses are walking off the job.
Another factor is how long the dispute between the Government and the union runs.
Some appointments not on strike days may also be delayed as more urgent procedures were cancelled need to be prioritised.
What determines which hospitals or NHS services will strike?
The RCN balloted nurses at 300 NHS hospitals and trusts and 178 came back with a valid result in favour of strike action.
What makes a valid strike action ballot differs depending on the trade union law across the UK nation.
In England and Scotland, 50 per cent of the eligible membership must vote for the ballot to be valid, and at least 40 per cent of votes must be in favour of the action for the result to count.
For Wales, at least 50 per cent of the eligible membership must vote but only a simple majority is needed to determine the result.
Northern Ireland has the least restrictions on strike action ballots, only a simple majority of those who vote is required with no minimum turnout threshold.
When could nurses go on strike?
Northern Ireland requires strike action to take place within one month of the ballot closing, so before December 3.
The law in England, Scotland and Wales states strike action has to be held within six months of the ballot closing, so by the start of May.
Have any dates been announced so far?
No. It is also unclear if the strike will be held continuously, as in for multiple days in a row, or on certain days spaced throughout the month.
Won’t a strike put patients in danger?
Unlike other staff groups who take strike action, nurses are required by law to maintain a minimum staffing level to keep patients safe.
Therefore, some nurses will be exempt from the strike to provide this minimum level of service.
The exact numbers remaining on the job will be negotiated locally between the RCN and each NHS Trust/Board.
What kind of NHS services could be scrapped?
Senior health officials have warned patients are expected to only receive a ‘bank holiday’ level of service on days nurses walk off the job.
This means vital cancer and kidney disease treatments and routine operations like knee or hip replacements could be axed, or rescheduled.
Other procedures and treatment that might be scrapped include chemotherapy and dialysis.
Emergency care is not expected to be impacted by strike action, as this is needed to ensure life-saving care is provided to the public.
Won’t some patients suffer from elective procedure being cancelled?
Yes. Patients on waiting lists for elective care often have a reduced quality of life as they live in pain for months at a time and can suffer health problems from a lack of treatment.
However, the RCN argues that improved pay is needed to help boost staffing in the NHS which is considered to be one of the main reasons contributing to long elective care waiting times in the first place.
If some nurses are still working what’s the point of a strike?
While life-saving care will be provided, a nursing strike is likely to lead to cancellation of hundreds of routine operations.
Similar large-scale strike action by junior doctors in 2016 led to the cancellation of 100,000 patient appointments.
Can nurses be sacked for striking?
No. NHS workers cannot legally be sacked if they participate in official and lawful industrial action.
The nurses regulator the Nursing and Midwifery Council, which has the power to strike off nurses from the profession, has also made it clear it will not penalise nurses for taking industrial action.
Are the strikes avoidable?
The RCN says the Government can stop the strikes if it agrees to meet their demands on pay.
However, the Government has refused to even say it will meet with the union following the result of the ballot.
What is the NHS doing to prepare for strike action?
At the start of November hospitals in England were ordered to plan a military-style operation to prepare for potential strike action.
Called Exercise Arctic Willow, the multi-day operation is designed to test their ‘preparedness’ for winter and will take place in mid-November.
This is an extension to the normal routine winter preparedness exercises carried out by trusts to prepare for seasonal problems like an increase in flu admissions.
Will the Government cave to RCN demands?
Unknown. But if the No10 gives in to nurses it will face pressure to provide similar pay rises to other NHS staff groups, with junior doctors, midwives and other health service staff also arguing for inflation busting pay rises.
At a time when state services are being asked to tighten their belts due to financial pressures the Government is likely to argue it can’t afford to pay NHS staff more than it has offered.
What are other staff groups doing? Is more industrial action on the way?
Nurses aren’t alone in their discontent with NHS pay.
A plethora of other staff groups are mulling over industrial action including potential strikes.
This week the union Unite announced its was expanding its NHS strike ballot to 100,000 members working in the health service in England and Wales.
The new ballot will incorporate nurses, as well as mental health staff, NHS dentists, paramedics as well as health service estate and admin staff.
Unite was previously balloting ambulance drivers in Scotland and England on potential strike action but said the situation in the NHS had prompted an expansion to other groups.
If the Unite ballot returns a yes result, the union said its members would strike in the New Year.
Other previously staff unions that have touted industrial action include the Royal College of Midwives which has asked its 50,000 members to vote in support of action when ballots open on November 11.
Two-thirds have already said they would be willing to strike in a preliminary poll.
More than 15,000 ambulance workers at 11 trusts in England and Wales are being balloted on industrial action over pay and ‘unsafe’ working conditions.
The GMB union said if the strikes went ahead, which could take place ahead of Christmas, it would be the biggest for three decades.
Some 8,000 members in Scotland last week voted ‘overwhelmingly’ in favour of industrial action.
And the Chartered Society of Physiotherapy said more than eight in 10 of its 60,000 members across the UK are prepared to strike.
Members in Scotland last week voted in favour of strike action. Voting in England closes today, while members in Wales have until December 12 to post their ballot.
It makes the first time members have been balloted over pay in the CSP’s 100-year history.
Meanwhile, the British Medical Association will ballot junior doctors in early January on whether it should strike over pay.
A strike goes against what it means to be a nurse. I beg my colleagues to think again, writes NHS staff nurse CARMELAH JACOBS
Six months ago I received the late-night phone call that many of us dread.
My 75-year-old mum had suffered a sudden cardiac arrest and had been taken to a London hospital, where doctors were battling to save her life.
My husband and I live more than 200 miles away in the north of England and, by the time we had made the frantic three-and-a-half-hour drive to her bedside in the small hours, it was too late. My beloved mum had already passed away.
I was devastated, yes. But I will never forget the kindness of the nurses who greeted me in my distress.
These were the men and women who had patiently sat by my mother’s bedside in her final moments – and allowed me in turn to stay with her for hours saying goodbye. ‘Take as long as you need,’ one told me.
Industrial action is expected to begin before Christmas, with reports it will take place over two dates, potentially a Tuesday and a Thursday
That compassion is a quality that, as a nurse myself, I value above almost everything else in my profession.
And while I have remembered my mum every day since, in recent days her final hours have been particularly on my mind.
After all, some of those same nurses who cared for her may now have voted to strike – for the first time in the Royal College of Nursing’s (RCN) 106-year history.
If such a strike action had unfolded on the day she died, my mum’s final hours – and my goodbyes – may have been very different indeed.
That is just one reason I feel enormously saddened by my peers’ decision to strike. There is no question that this action will have devastating consequences for countless patients and their families.
While the RCN has insisted that emergency care will remain unaffected, thousands of operations, chemotherapy and dialysis appointments will be cancelled.
Meanwhile on our wards, I have no doubt that it will mean some patients – people like my mum – may perhaps die alone or be left without the tender touch of a carer.
And that’s why I am urging my colleagues to think again about the action. Should they proceed, it will go against the very tenet of what it means to be a nurse – that the patient always comes first.
Should they proceed, it will go against the very tenet of what it means to be a nurse – that the patient always comes first
That vital principle is recorded in black and white in the Nursing and Midwifery Council code of standards (‘[you must] promote health and prevent ill health’).
Nurses do not, like newly qualified physicians, take the Hippocratic Oath, swearing to uphold a number of professional ethical standards. But what we are there to do unquestionably is to serve our patients. It is instilled into each of us from the moment we put on our uniform, until the moment we retire.
And it is a principle I first absorbed when, 17 years ago, I joined the nursing profession, following in the footsteps of my late mother, Gina, who was a nurse herself for more than 20 years.
My siblings and I were raised on the stories – some sad, some funny – that she told about her patients and the doctors she worked alongside.
She believed passionately, as do I, that nursing was a vocation. She was never interested in working for the money but she was proud of what she did.
It was truly inspiring and I have never once regretted my career choice; not even during the darkest days of the Covid pandemic, when I would return home to my husband and two young children exhausted and traumatised about what had unfolded on my ward.
My mother, who was a nurse herself for more than 20 years, believed passionately, as do I, that nursing was a vocation. She was never interested in working for the money but she was proud of what she did
I believed then – and I believe now – that this is what I signed up for. As nurses, we are trained to be prepared for anything. And while the Covid pandemic created the most extraordinary challenges many of us will ever see in our working lives, we all just had to get on with it.
That’s the job, one you don’t go into for self-advancement, or for money. You do it because you want to give back, and to support and help people through what can be some of the scariest and most important moments in their lives.
In return it can be enormously enriching, inspiring and humbling. Listen to the news and you may hear the occasional horror story – but what you don’t hear about are the countless meaningful connections made day in, day out.
The elderly woman who cries while you hold her hand. The desperately ill young man who breaks out in laughter for the first time in weeks at a joke you made. The former patient who spots you in the street and comes over to thank you for helping them out.
Of course, I understand my colleagues’ concerns and frustrations.
I know that in the busy hospital department where I work in Greater Manchester, morale is low among my fellow nurses.
We’re all working longer hours, covering areas we are not experienced in and frantically trying to make up for staff shortages.
There’s no question Britain is suffering a chronic lack of nurses: when I qualified I used to be responsible for between six to eight patients. Now it’s 12 to 14. Yet while workloads have increased, pay has not kept pace.
To many, the 3 per cent pay rise we were given last year in recognition of work during the pandemic was not enough.
But while I accept that disgruntlement, I also accept that the rough starting salary for nurses of £27,000 – rising to nearly £55,000 for the most senior – is not far off the average salary for many workers across the UK. I also appreciate that many public sector workers have experienced a total pay freeze.
Of course, as the cost of living soars, it is little surprise that many nurses are feeling undervalued.
In fact, I share that sentiment myself. But here’s the thing: I will not be joining my peers and colleagues on the picket line when the time comes. And I never will. Because when you have chosen to work in a caring profession, striking is never the answer.
Whatever grievances we nurses have should be addressed through proper negotiation and discussion, not through walk-outs which, whatever the rhetoric of union bosses, may lead to patient deaths. Even one unnecessary death is one too many.
But I also cannot help thinking of all the other direct consequences left in the wake of striking nurses – less dramatic on paper than death, but still devastating.
I also fear for how strike action will be received among the public – many of whom are hugely grateful for and supportive of NHS workers particularly since the pandemic
I’m talking about the hands not held, the small compassionate gestures not done, or the words of comfort unspoken to grieving relatives – as I myself was just a few months ago.
That is the grim reality of strike action, and it is why I will continue go into work as normal, to visit my ward and look after my patients.
No doubt it will mean working back-to-back shifts to make up for staff shortfalls – all the while knowing that whatever I do will still not be enough – but I and those who join me will do what we can.
Otherwise, I would never be able to forgive myself.
I also fear for how strike action will be received among the public – many of whom are hugely grateful for and supportive of NHS workers particularly since the pandemic.
But goodwill is not limitless, and strikes risk undermining it.
That it is why I am calling – begging – for my nursing colleagues who voted to strike to look into their hearts and think again.
Published by Associated Newspapers Ltd
Part of the Daily Mail, The Mail on Sunday & Metro Media Group
