NHS strikes: hospital leaders concerned at threat of overlapping nurse and junior doctor walkouts

Newly announced nurses' strikes threaten to cause a staffing a headache for England's hospitals, with management already contending with the looming threat of further junior doctor walkouts.

Members of the Royal College of Nursing (RCN) voted on Friday (14 April) to reject a government pay deal, which included a 5% pay rise this year and a cash payment for last year. Instead, the union announced fresh strike action, starting with a 48-hour walkout later this month.

The announcement came in the midst of a four-day strike by junior doctors working for the NHS, causing an estimated 350,000 hospital appointments to be cancelled. With little movement from government, the British Medical Association (BMA) says there is likely to be further strike action.

This has sparked concern from hospital management about patient safety and safe staffing levels, especially if the two strikes line up.

Will nurse strikes coincide with junior doctors strikes?

While further strike dates for junior doctors have not yet been confirmed, senior NHS sources have told The Telegraph they have serious concerns further strikes could be planned for the three upcoming bank holidays in May – on the 1st, 8th and 29th – as the union attempts to maximise its impact on the health service.

The newly-announced 48-hour nurse walkout will begin at 8pm on 30 April - also covering the first May bank holiday weekend.

While NHS contingency plans will be put in place for any upcoming strikes, the prospect of the two simultaneous strikes has concerned hospital bosses, who have struggled to secure cover for overnight junior doctor shifts during strikes. Matthew Taylor, chief executive of the NHS Confederation, called the situation “heartbreaking”.

He said he hoped everyone who needed urgent care would receive it, but added: “There’s no point hiding the fact that there will be risks to patients – risks to patient safety, risks to patient dignity – as we’re not able to provide the kind of care that we want to.”

During the strikes, staff who were still working had prioritised emergency and urgent care over some routine appointments and procedures to ensure safe care for those in life-threatening situations. It meant hundreds of thousands of appointments and operations have been rescheduled.

This is likely to continue to be an issue for patients. The RCN says the upcoming nurses' action will not include any derogations this time - meaning the new strike will also involve nursing staff working in emergency departments, intensive care units, cancer care and other services that were previously exempt.

Why are nurses striking, and why did they reject the offer?

In a letter to Health Secretary Steve Barclay to inform him of fresh strike action, RCN general secretary Pat Cullen wrote: "What has been offered to date is simply not enough."

The Government needs to increase what has already been offered, she said, "and we will be highly critical of any move to reduce it". Since talks in February, the RCN has seen the pressures on the NHS continue to increase.

"The crisis in our health and care services cannot be addressed without significant action that addresses urgent recruitment and retention issues and nursing pay to bring this dispute to a close urgently. Until there is a significantly improved offer, we are forced back to the picket line."

Ms Cullen continued: "Meetings alone are not sufficient to prevent strike action and I will require an improved offer as soon as possible. In February, you opened negotiations directly with me and I urge you to do the same now. After a historic vote to strike, our members expect a historic pay award."

Why are junior doctors striking?

The BMA claims junior doctors in England have seen a 26% real-terms pay cut since 2008/09 because pay rises have been below inflation. The union has asked for a full pay restoration that the government said would amount to a 35% pay rise.

Many doctors say with the current cost of living crisis, they have been left living on the breadline, using foodbanks and borrowing money for rent. Some junior doctors are reportedly earning just £14 an hour.

But the government has not budged - nor come forward with a new offer after the latest strikes. While it is open to attending mediation with the unions, ministers have said they will need to call off the threat of further strike action first.