The NHS is braced for a summer of mayhem after nurses rejected a pay deal last night – raising fears they could co-ordinate future strikes with junior doctors.
The Royal College of Nursing (RCN) confirmed that 54 per cent of balloted members voted to reject the deal, which was offered after the union launched a historic wave of industrial action this winter.
In the deal, which the union recommended to members, nurses would have received a 5 per cent pay rise this financial year plus a one-off bonus averaging 6 per cent.
The RCN, which on Friday said the offer was ‘simply not enough’, announced its members would hold a 48-hour strike from 8pm on April 30 to 8pm on May 2.
The BMA last night failed to rule out junior doctors and nurses coordinating strikes for maximum effect in the future, in worrying news for patients who have already had appointments cancelled.
Pat Cullen (pictured: centre), the union’s general secretary and chief executive, said ‘After a historic vote to strike, our members expect a historic pay award’
The result means nurses will return to the picket line for 48-hours on April 30. Pictured RCN members during a previous strike on February 6
It comes after Unison, which represents hundreds of thousands of nurses, paramedics and hospital staff, confirmed its members in England had accepted the same pay offer.
In a major escalation, striking nurses will refuse to deliver any services, with nurses working in A&E, intensive care and cancer wards picketing for the first time.
This means critical ‘life and limb’ care will be affected for the first time during a nurses strike in England.
This marks an escalation in the dispute with Government over pay and echoes the type of strike action currently underway by junior doctors.
Pat Cullen, chief executive of the union, said its nurses are ‘forced back to the picket line’ until there is a ‘significantly improved offer’.
Ms Cullen said: ‘After a historic vote to strike, our members expect a historic pay award.’
The union had previously campaigned for a 18 per cent pay rise.
The RCN’s compromise of 5 per cent attracted condemnation from portions of the college’s membership.
This upcoming strike action by the RCN is the last it can legally hold, as the union is only allowed to organise strikes within six months of its original industrial action ballot.
But the union officials said they will organise another ballot of members in England so further strikes can take place.
The news is a bitter blow to patients who have already had more than 350,000 appointments and operations cancelled due strikes by various NHS staff groups.
The prospect of further days of industrial action will do increasing damage to efforts to reverse spiralling NHS waiting lists.
Rishi Sunak made cutting waiting lists one of his five priorities in a keynote speech in January, challenging the public to judge him on his ability to deliver.
Junior doctors remain locked in their own pay dispute and have threatened months of disruption and more strikes if ministers do not agree to their demands for a 35 per cent rise.
Health leaders say that doctors put patients at risk by walking out for four days this week, when an estimated 350,000 operations and appointments were cancelled – making it the biggest strike in the history of the NHS.
If the two unions were to co-ordinate future action by walking out on the same days or alternating days, the impact could be even more devastating.
In the letter to Health Secretary Steve Barclay, Ms Cullen said: ‘What has been offered to date is simply not enough.
‘The Government needs to increase what has already been offered and we will be highly critical of any move to reduce it.
‘Until there is a significantly improved offer, we are forced back to the picket line. Meetings alone are not sufficient to prevent strike action and I will require an improved offer as soon as possible.’
She urged Mr Barclay to meet to open negotiations as soon as possible.
The turnout among RCN members employed on NHS Agenda for Change contracts in England was 61 per cent.
It had initially demanded a 19 per cent pay rise and has staged six days of strikes since mid-December, leading to the cancellation of thousands of appointments.
The British Medical Association, which represents junior doctors, will end its 96-hour walkout today and is calling on the Government to attend talks at conciliation service Acas.
Professor Philip Banfield, BMA council chairman, said: ‘We support the nurses in their rejection of a derisory pay offer and stand by them in their ongoing campaign.’
It is understood the BMA will give the Government time to attend talks at Acas before holding another strike, meaning it is unlikely to take action with the RCN on April 30.
But it last night failed to rule out co-ordinating future strikes.
Tory MP Paul Bristow, who sits on the Commons health and social care committee, said: ‘It has already been suggested these strikes could be causing excess deaths. They are certainly causing unnecessary suffering.
‘I am sure any co-ordinated action would lose public support fast.’
The Government pay offer applied to more than 1million NHS staff on the Agenda for Change Contract, which includes nurses, physiotherapists and ambulance workers.
Unison, which represents more NHS workers than any of the other unions, yesterday said its members had accepted the offer, with 74 per voting in favour on a turnout of 53 per cent.
Unite and the GMB will announce the result of their ballots in two weeks’ time.
Mr Barclay welcomed the Unison vote but said of the RCN: ‘Their decision to escalate strike action with no exemptions, based on a vote from a minority of members, is hugely concerning.
‘The NHS staff council, which recommended this offer, covers a number of trade unions who are continuing to vote, and I hope this offer secures the support of a majority of members.’
Tory MP Chris Green, another member of the health and social care committee, said: ‘Any co-ordinated action to have junior doctors and nurses go on strike together would be designed to cause as much disruption to health care as possible and would be a so much more wrongful decision when Unison has shown that a sensible compromise is within reach.’
The NHS Staff Council, which includes health unions on the Agenda for Change contract, will meet on May 2 to discuss their ballot results. A deal needs just a simple majority to pass so it could be accepted despite RCN members rejecting it.
The union’s rejection threatens to blow a hole in Prime Minister Rishi Sunak’s efforts to portray himself as the country’s ‘Fixer’.
It puts to end the dispute that saw tens of thousands of union members strike over the winter months, leading to mass disruption across the health service
He is relying on turning the tide on a daunting array of issues if the Tories are to have any chance of shutting out Labour at the general election, pencilled in for next Autumn.
He received a big boost last month when his new post-Brexit package for Northern Ireland sailed through the Commons with a minimal revolt by his own MPs.
However, although the victory cemented Mr Sunak’s control of his party, it has failed to convince the DUP to resume powersharing at Stormont.
Mr Sunak has made other key pledges on halving inflation – which has been staying stubbornly high – and stopping the Channel migrant boats. He has already seemingly watered down the timetable for the latter promise.
Settling the industrial action by nurses, who enjoy the strongest support from the UK public, was seen as a massive step towards stabilising the Government.
Continuing strikes will jeopardise Mr Sunak’s hopes of eradicating the huge treatment backlog after Covid and cutting waiting times.
With Labour’s poll lead still well into double-digits, Tories view improvements in the cost of living crisis and key public services as the only path to winning the election.
A Government spokesperson said the RCN ballot result is ‘hugely disappointing’.
They said: ‘Following constructive discussions, all parties agreed this was a fair and generous offer which is demonstrated by Unison, representing the largest share of the NHS workforce, choosing to accept it.
‘The fact that the Royal College of Nursing has announced an escalation in strike action with no derogations, based on a vote from the minority of the nursing workforce, will be hugely concerning for patients.
‘Hundreds of thousands of Agenda for Change staff continue to vote in ballots for other unions over the next two weeks and we hope this generous offer secures their support.’
NHS Providers director of communications Adam Brimelow called the RCN rejection ‘extremely worrying’.
He said: ‘It’s really important that the unions and Government find a way through this to prevent more strikes and let the NHS focus on its big challenges, including cutting waiting lists and transforming services, instead of having to resort to ‘all hands on deck’ just to get through the day.’
The RCN rejection comes after Unison members in England, who include hundreds of thousands of paramedics, nurses and hospital staff, voted to accept the Government’s pay offer.
Three-quarters of balloted members accepted the sum, which amounts to a one-off bonus for last year and five per cent pay rise this year.
The Government said the result shows that the pay offer is ‘fair and reasonable’.
Sara Gorton, head of health at the union, said: ‘Clearly health workers would have wanted more, but this was the best that could be achieved through negotiation.
‘Over the past few weeks, health workers have weighed up what’s on offer. They’ve opted for the certainty of getting the extra cash in their pockets soon.
‘It’s a pity it took several months of strike action before the Government would commit to talks.
‘Unions told ministers last summer the £1,400 pay rise wasn’t enough to stop staff leaving the NHS, nor to prevent strikes. But they didn’t want to listen.’
She said NHS staff were ‘forced to strike’ and lost ‘money they could ill afford’, while the health service and patients ‘suffered months of unnecessary disruption’.
Ms Gorton urged the Government, which is still consulting with other unions representing healthcare staff, to ‘ensure NHS workers get the wage rises they’ve voted for at the earliest opportunity’.
She added: ‘This vote might end Unison’s dispute, but it doesn’t solve the wider staffing emergency affecting every part of the NHS.
‘Now, the Government must work with unions to bring about a sustained programme of investment in the workforce.
‘Lessons must also be learned. The mistakes of the past few months cannot be repeated. It’s time for a whole new approach to setting pay across the NHS.’
The one-off payment for 2022/23 will see staff get between £1,655 and £3,789, depending on their pay.
This is equal to 8.2 per cent for the lowest paid and around 6 per cent for nurses and midwives.
It is in addition to the £1,400 NHS staff received for 2022/23 last September.
The 2023/24 wage rise is worth at least £1,065 and would raise the lowest hourly rate in the NHS in England to £11.45 an hour, or £22,383 a year.
A Government spokesperson said: ‘The decision by members of Unison, the largest NHS union, to accept the pay offer recommended by their leadership demonstrates that it is a fair and reasonable proposal that can bring this dispute to an end.
‘Under the offer, an Agenda for Change employee at the Band 6 entry point – such as a physiotherapist, paramedic or a midwife – will receive over £5,100 across last year and this year, with over £2,000 in bonus payments arriving as a lump sum in pay cheques by summer.
‘Hundreds of thousands of Agenda for Change staff continue to vote in ballots for other unions over the next two weeks and we hope this generous offer secures their support.’
Where will nurses strike on April 30?
The RCN has said the 48-hour, no exceptions walkout will be held at the following NHS workplaces in England.:
East Midlands
Derbyshire Community Health Services NHS Foundation Trust
Derbyshire Healthcare NHS Foundation Trust
East Midlands Ambulance Service NHS Trust
Kettering General Hospital NHS Foundation Trust
NHS Derby and Derbyshire ICB
NHS Nottingham and Nottinghamshire ICB
Northamptonshire Healthcare NHS Foundation Trust
Nottingham University Hospitals NHS Trust
Nottinghamshire Healthcare NHS Foundation Trust
Eastern
Cambridge University Hospital NHS Foundation Trust
Cambridgeshire and Peterborough NHS Foundation Trust
Cambridgeshire Community Services NHS Trust
East Suffolk and North Essex NHS Foundation Trust
Hertfordshire Community NHS 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
Norfolk and Norwich University Hospitals NHS Foundation Trust
Norfolk and Suffolk NHS Foundation Trust
Norfolk Community Health and Care
NHS Trust Royal Papworth Hospital NHS Foundation Trust
West Suffolk NHS Foundation Trust
London
Great Ormond Street Hospital for Children NHS Foundation Trust
Guys and St Thomas NHS Foundation Trust
Hounslow and Richmond Community Healthcare NHS Trust
Imperial College Healthcare NHS Trust
Kings College Hospital NHS Foundation Trust
NHS North Central London ICB
NHS South West London ICB
Royal Marsden NHS Foundation Trust
St George’s University Hospitals NHS Foundation Trust
Tavistock and Portman NHS Foundation Trust
University College London Hospitals NHS Foundation Trust
North West
Alder Hey Children’s NHS Foundation Trust
Bridgewater Community Healthcare NHS Foundation Trust
Cheshire and Wirral Partnership NHS Foundation Trust
Countess of Chester Hospital NHS Foundation Trust
Lancashire Teaching Hospitals NHS Foundation Trust
Liverpool Heart and Chest Hospital NHS Foundation Trust
Liverpool University Hospitals NHS Foundation Trust
Liverpool Women’s NHS Foundation Trust
Mersey Care NHS Foundation Trust
Mid Cheshire Hospitals NHS Foundation Trust
NHS Cheshire and Merseyside ICB
NHS Lancashire and South Cumbria ICB
North West Ambulance Service NHS Trust
St Helens and Knowsley Teaching Hospitals NHS Trust
Tameside and Glossop Integrated Care NHS Foundation Trust
The Christie NHS Foundation Trust
The Clatterbridge Cancer Centre NHS Foundation Trust
The Walton Centre NHS Foundation Trust
Wirral Community Health and Care NHS Foundation Trust
Wirral University Teaching Hospital NHS Foundation Trust
Wrightington Wigan and Leigh NHS Foundation Trust
Northern
Country Durham and Darlington NHS Foundation Trust
Gateshead NHS Foundation Trust
North of England Commissioning Support (NECS)
North East Ambulance Service NHS Trust
Northumbria Healthcare NHS Foundation Trust
South Tees Hospitals NHS Foundation Trust
The Newcastle Upon Tyne Hospitals NHS Foundation Trust
University Hospitals of Morecambe Bay NHS Foundation Trust
South East
East Sussex Healthcare NHS Trust
Kent Community Health NHS Foundation Trust
NHS Kent and Medway ICB
NHS Surrey Heartlands ICB
Queen Victoria Hospital NHS Foundation Trust
South East Coast Ambulance Service
Sussex Community NHS Foundation Trust
Sussex Partnership NHS Foundation Trust
University Hospitals Sussex NHS Foundation Trust
Oxford Health NHS Foundation Trust
Oxford University Hospitals NHS Foundation Trust
Portsmouth Hospitals NHS Trust
Royal Berkshire NHS Foundation Trust
Solent NHS Trust
South Central Ambulance Services NHS Foundation Trust
Southern Health NHS Foundation Trust
University Hospital Southampton NHS Foundation Trust
South West
Avon and Wiltshire Mental Health Partnership NHS Trust
Cornwall Partnership NHS Foundation Trust
Devon Partnership NHS Trust
Dorset County Hospital NHS Foundation Trust
Dorset Healthcare University NHS Foundation Trust
Gloucestershire Health and Care NHS Foundation Trust
Gloucestershire Hospitals NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
NHS Bath, North East Somerset, Swindon and Wiltshire ICB
NHS Devon ICB (One Devon)
NHS Dorset ICB (One Dorset)
NHS Gloucestershire ICB (One Gloucestershire)
North Bristol NHS Trust
Royal Cornwall Hospitals NHS Trust
Royal Devon University Healthcare NHS Foundation Trust
Royal United Hospitals Bath NHS Foundation Trust
Salisbury NHS Foundation Trust
Somerset NHS Foundation Trust
South Western Ambulance Service NHS Foundation Trust
Torbay and South Devon NHS Foundation Trust
University Hospitals Bristol and Weston NHS Foundation Trust
University Hospitals Dorset NHS Foundation Trust
University Hospitals Plymouth NHS Trust
West Midlands
Birmingham Women’s and Children’s NHS Foundation Trust
Dudley Integrated Health and Care NHS Trust
Herefordshire and Worcestershire Health and Care NHS Trust
Midlands and Lancashire CSU
Midlands Partnership NHS Foundation Trust
NHS Birmingham and Solihull ICB (BSol ICB)
NHS Black Country ICB
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Shropshire Community Health NHS Trust
The Royal Orthopaedic Hospital NHS Foundation Trust
University Hospitals Birmingham NHS Foundation Trust
Worcestershire Acute Hospitals NHS Trust
Yorkshire and the Humber
Barnsley Hospital NHS Foundation Trust
Bradford Teaching Hospitals NHS Foundation Trust
Harrogate and District NHS Foundation Trust
Leeds Community Healthcare NHS Trust
NHS North West Yorkshire ICB
Sheffield Children’s NHS Foundation Trust
Sheffield Health and Social Care NHS Foundation Trust
Sheffield Teaching Hospitals NHS Foundation Trust
The Leeds Teaching Hospitals NHS Trust
York and Scarborough Teaching Hospitals NHS Foundation Trust
National employers
Health Education England
NHS Blood and Transplant
NHS England NHS Resolution
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