Talks between NHS leaders and the Royal College of Nursing will go to the wire over which services will be protected from the impact of strike action in England, Wales and Northern Ireland, as nurses prepare to walk out on Thursday for the first time in the union’s history.
The union has agreed exemptions for several vital services, including chemotherapy, dialysis, critical care units and paediatric A&E. Further so-called “derogations” were added on Tuesday, including emergency cancer care.
However, Danny Mortimer, chief executive of NHS Employers, said: “There are areas where we are disappointed that we have not been able to make more progress with the RCN.”
In a letter sent on Wednesday to NHS leaders in England, seen by the Financial Times, Mortimer wrote that “the limited national derogations for cancer services” were “a particular area of worry”.
The nurses’ strikes are part of a wave of industrial action sweeping across Britain that could rival the “winter of discontent” in 1978-79, as ballots covering more than a million public sector workers conclude.
Mortimer said he would “continue to meet with the RCN throughout this week”, together with Ruth May, England’s chief nursing officer, and Stephen Groves, head of emergency preparedness resilience and response.
Steve Barclay, health and social care secretary, has refused to discuss the RCN’s pay claim on the grounds that the government has accepted the recommendation of the independent pay review body and does not have a role to play in negotiations.
In his letter, Mortimer warned that “further strike dates will be announced by the RCN for January 2023 and beyond” unless the government “indicates a willingness to negotiate on pay-related matters”.
It was likely that these strikes “will be for a longer time period on each occasion and will cover a greater number of organisations in England”, he said.
A total of 176 NHS trusts, out of 311, reached the legal threshold for strike action last month and as many as 100,000 nursing staff in England, Wales and Northern Ireland will walk out at about half of those locations on Thursday.
Nurses in Scotland have suspended the threat of action as they consider a separate pay offer from the Scottish government averaging an increase of 7.5 per cent.
After last-ditch talks to halt strike action in the rest of the UK failed on Monday, Pat Cullen, RCN general secretary, accused Barclay of “[closing] the books” by refusing to discuss the union’s demand for a pay increase of 5 per cent above retail price inflation, which stood at 14 per cent in November.
Cullen highlighted official data that showed average public sector pay grew by just 2.7 per cent between August and October 2022 compared with 6.9 per cent in the private sector.
However, as the union seeks to ratchet up pressure on the government, uncertainty remains about the impact of industrial action, which will affect about 65 trusts in England and Wales and a further 11 health organisations in Northern Ireland.
The RCN said it was the responsibility of each employer to ensure services were safe. If an employer was not able to maintain services, employers could request additional derogations, which would be considered by strike committees.
Should a major incident be declared in a trust area during the strikes, nurses would leave picket lines to help, said the RCN.
