The NHS could find itself in an extremely worrying and challenging time this winter if nurses and junior doctors jointly walk-out in their desperate bid for better pay.

Strike action: Charlie grills Pat Cullen on nurse strikes

Patients face NHS strike misery for the rest of the year after union leaders warned nurses are ready to walkout until Christmas to secure higher pay. The Royal College of Nursing is also refusing to rule out joint industrial action with junior doctors that would push the health service to the brink during the busier winter months.

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Downing Street insiders insisted there was no chance of an end to the deadlock while NHS staff take to the picket line. But RCN chief Pat Cullen ruled out calling off the strikes.

She said: “No, our nurses will absolutely not do that. We have strike action for the end of this month and the beginning of May.

“Then we will move immediately to ballot our members. If that ballot is successful it will mean further strike action right up until Christmas.”

Just four weeks ago, Ms Cullen wrote a blog advising RCN members to accept the deal she had secured after intensive negotiations with Health Secretary Steve Barclay.

Nurses strikes could last all year

Nurses strikes could last all year (Image: Getty)

She said the offer was “not the first offer, it’s the final offer” and the union had already said no to a “dozen earlier versions”.

“The talks did not stop until we had got every penny the government was going to give,” she added. “If I believed the government was going to give more, the talks would still be ongoing

Ms Cullen warned that it was a myth that if the RCN rejected the deal it would get more next time. She said that while they did not secure everything they asked for, negotiations work by “compromise and agreement”.

“These talks will not be reopened if members reject this pay offer,” the RCN general secretary said.

  RCN chief Pat Cullen ruled out calling off the strikes

RCN chief Pat Cullen ruled out calling off the strikes (Image: Shutterstock)

Ms Cullen yesterday defended pursuing fresh strikes despite previously advising members to take the deal.

“I said it was the best offer that we could get from this government at this point in time,” she told the BBC’s Laura Kuenssberg On Sunday programme.

“Our members have said it’s not fair and it’s not reasonable and I absolutely support them in that.”

The RCN leader said “there are no plans in place to co-ordinate strikes with doctors” but repeatedly refused to rule out taking action at the same time as junior doctors.

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NHS nurses in emergency departments, intensive care and cancer wards will take industrial action for the first time in a 48 hour walkout starting at 8pm on April 30 after dropping “derogations” protecting critical services.

Nurses were among one million health service workers offered a five percent increase in April and a one off bonus of at least £1,655 to top up the last financial year’s salary settlement.

They turned down the offer by 54 percent to 46 percent on a turnout of just 61 percent, meaning only one in three members wanted to reject the deal.

The decision puts nurses at odds with Unison NHS workers who voted decisively to accept the joint pay deal. Other unions are still balloting on whether to accept the deal.

A Downing Street source said the next steps will not be set out until the results are all in. The insider said that calling off strikes was a “pre-condition” of any future negotiations.

Steve Barclay with Rishi Sunak

Steve Barclay with Rishi Sunak (Image: Getty)

The Health Secretary urged Ms Cullen to reconsider the strike and said he would welcome a meeting to discuss avoiding strikes.

In a letter addressed to the RCN, Mr Barclay said the most recent pay offer recommended to RCN members was a “fair and reasonable settlement”.

He added: “After you recommended the deal be accepted, I am disappointed that given the turnout, a rejection from less than half of your members was sufficient for a narrow rejection overall.”

Mr Barclay went on: “Given that you supported the offer we reached together, and that your ballot saw a very narrow result, I am also both disappointed and concerned that the Royal College of Nursing has chosen to announce 48 hours of continuous strike action without consultation of other staff council unions or waiting for the full staff council consultation to complete.

“The decision to refuse at this stage any exemptions for even the most urgent and life-threatening treatment during this action will, I fear, put patients at risk.”

He added: “The strike action you have called will cause significant disruption at a time when the NHS is already under extreme pressure. I urge you to reconsider your planned strike on 30 April – 2 May.”

‘Incredibly worrying’ 

Conservative Party chairman Greg Hands said the deal was a “full and final” pay offer. He said: “We think that we’ve made a fair and reasonable offer. It is a full and final offer.”

Health leaders warned the breakdown in the negotiations was “incredibly worrying”. Saffron Cordery, NHS Providers deputy chief executive, said: “We’re really worried about the impact on an ongoing basis of these strikes.

“We know they aren’t sustainable and we’ve really got to make sure that we actually find a solution to them, and that’s in the hands of the unions and it’s in the hands of the Government. This is a negotiation and let’s handle it as such.”

She added: “We’ve had conversations in our organisations and across the trust leaders about how this would look and it is really incredibly worrying.

“We know that when we’ve had the derogations in the past it’s felt like there’s been that safety net there, protection.

“That will disappear and I think that we will find ourselves in a situation where already we are devoting so much resource to keeping patients safe in an emergency – that’s what has to happen in this situation.”

Matthew Taylor, the chief executive of the NHS Confederation, said the possibility of combined industrial action would see the health service enter “unchartered territory”.

“When we’re talking about derogations irrespective of the past, being excluded in this industrial action, so it does affect, for example, emergency services,” he said.

“And when we’re talking about the possibility of combined industrial action, this type does take us into unchartered territory.”

Mr Taylor added: “The people that I represent will have to spend a great deal of time doing the detailed planning, the detailed negotiation with trade unions locally to try to ensure that we protect life and limb.”

“We do want to avoid this industrial action.”

Analysis by Sam Lister

Warnings that nurses are preparing to hold walkouts until Christmas will strike fear into the hearts of people who rely on the NHS for care.

That they could end up coordinating industrial action with junior doctors will leave many in a state of despair.

What a sad state of affairs when there was such hope just a few weeks ago that compromise on both sides had led to a deal that included an acceptable pay bump and a bonus.

Royal College of Nursing chief Pat Cullen has told the government it must offer more money on top of the offer she recommended to her members just a few weeks ago.

Despite just three in ten members rejecting the deal once turnout is taken into account, the union has upped the stakes by announcing emergency services and cancer care will be hit by walkouts later this month.

A new ballot in May will be held to give a new six month mandate for strike action. 

But there is a real possibility that as the action becomes more radical, nurses will benefit from the extra pay within weeks.

The Royal College of Nursing is just one of a number of unions involved in accepting the government’s deal as it covers around one million NHS workers across different professions. 

Unison, the largest of those to ballot members, overwhelmingly backed the deal last week. 

But two others, the GMB and Unite, do not close their votes until 28 April.

Wisely, Downing Street is carefully avoiding being drawn into what happens next until those results are in.

Negotiations across so many organisations for one pay settlement is a messy business.

If the GMB and Unite, which represent ambulance workers and 999 call handlers among others, follow Unison’s lead, the deal could be rubber stamped at an NHS staff council on May 2 and paid out soon after.

Following the RCN’s lead, however, is likely to mean distress for patients and hardship for striking workers for the rest of the year.