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NHS Disruption 'Inevitable' as Nurses and Ambulance Workers Walk Out in England

The NHS is braced for its worst day of industrial action as tens of thousands of healthcare workers walk out in a dispute over pay. Today's action – set to be the largest strike in the history of the NHS – could also have the biggest impact on health services so far, with nurses and ambulance staff in England coordinating action on the same day for the first time.

In Wales, nurses, midwives, physiotherapists, and most ambulance workers agreed to call off industrial action after the Welsh Government put forward an enhanced pay offer.

In England, members of the Royal College Nursing (RCN) are beginning 2 days of strike action at 73 trusts compared with 44 in December and 55 in January. Routine procedures will be hardest hit, whilst urgent and emergency care will not be directly affected. NHS England urged patients to seek emergency care if needed and attend any appointments as planned unless contacted to rearrange. NHS Medical Director Sir Stephen Powis said plans were in place to minimise the effects of strikes but that "disruption is inevitable".

Government Urged to be 'Proactive'

The RCN has appealed to Prime Minister Rishi Sunak, who has listed the NHS as one of his five priorities needing urgent attention, to join the negotiations and help settle the dispute. Last week, England's Health and Social Care Secretary, Steve Barclay, said he was "engaging" with unions and described talks as "constructive". But Health Minister Maria Caulfield, told Sky News: "We've been pretty clear that we're not going to look at the current year's pay award that was agreed in April by the unions and by the Government." Instead, ministers were focusing on next year's pay round, she said.

NHS Providers called on the Government to be "proactive" in negotiations with trade unions and come to an agreed settlement. Speaking on BBC Radio 4's Today programme, chief executive Sir Julian Hartley said: "We do expect to have significant disruption in terms of planned care, outpatients and elective appointments, but obviously making sure that we deliver the priority of patient safety for urgent and emergency care.

"We can't go on with a series of industrial actions that really take us away from focusing on those priorities because I can't overstate the amount of work that goes on in organisations to manage and mitigate for industrial action, and our focus needs to be on delivering for patients as an NHS in those key areas."

Improved Pay Offer in Wales

Strike action was suspended in Wales by the Royal College of Nursing and the main ambulance union, the GMB, pending consideration of a revised pay offer. However, Unite, which also represents ambulance staff, said it expected its members to take industrial action on Monday. Sharon Graham, the union's general secretary, said it would be "wholly premature" to call off industrial action while negotiations were ongoing.

Explaining the revised pay offer, a spokesperson for the Welsh Government said it "comprises an additional 3%, of which 1.5% is consolidated so will be in pay packets year-on-year, on top of the Pay Review Body recommendations, which have already been implemented in full".

The Welsh Government confirmed that the award would be backdated to April 2022. Health workers in Wales could see a further top up in their pay in the event of an improved offer to colleagues in England, subject to a funding calculation for devolved government under the 'Barnett formula'.

'No Place Left to Hide' for Rishi Sunak

Pat Cullen, the RCN's chief executive, said the decision by the Welsh Government to improve its pay offer left Rishi Sunak with "no place left to hide". She said: "If the other governments can negotiate and find more money for this year, the Prime Minister can do the same."

This week's industrial action in the health service involves:

  • Strikes by RCN nurses today and on Tuesday in 73 trusts in England
  • Ambulance workers and call handlers striking on both Monday and Friday across different parts of the country.
  • A strike by physiotherapists on Thursday

The British Medical Association is currently balloting junior doctors in England on taking strike action, with results expected on or soon after 20 February. A vote in favour could lead to a 72-hour walkout by junior doctors in March. Consultants in England are to be asked whether they would endorse a strike ballot in their dispute over pay and pension taxation.