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Nurses' strike: What is the dispute about and how will it affect patients? NHS strikes: Why are nurses and ambulance staff taking industrial action?
(23 days later)
Nurses are to take strike action for two days in the lead up to Christmas. Some NHS nurses and ambulance staff are striking over pay in the run-up to Christmas.
Walkouts have been announced by the Royal College of Nursing (RCN) in England, Wales and Northern Ireland on 15 and 20 December. The dispute between the government and NHS unions is over pay.
What is the nurses' dispute about? When are NHS staff striking?
Pay. The RCN is calling for a rise of 5% above the RPI inflation rate - currently above 14%. No UK nation has offered a pay rise close to that. Nurses
NHS staff in England and Wales - including nurses - have been given an average increase of 4.75%. The lowest paid were guaranteed a rise of at least £1,400. They will strike for a second time on 20 December, having also walked out on 15 December.
In Northern Ireland, nurses are yet to receive a pay award because there is no working government. The action involves about a quarter of hospitals and community teams in England, all health boards in Northern Ireland, and all but one in Wales. Turnout was too low in nearly half of NHS trusts in England for strikes to go ahead. Nurses are not striking in Scotland while a pay offer is considered.
In Scotland, NHS staff were initially offered 5%, but that has been changed to a flat rate of just over £2,200. That is just over 8% for a newly qualified nurse. Fresh talks mean there will be no strike action for the time being. Ambulance staff
The young NHS workers who are voting yes Some workers in England and Wales will strike on 21 and 28 December.
Which workers are allowed to go on strike? The action will involve paramedics, control room staff and support workers.
Why are so many workers going on strike? The three main ambulance unions - Unison, GMB and Unite - will take part in the first strike. GMB union members will strike again on 28 December.
The RCN says this year's below-inflation pay award followed years of squeezes on nurses' salaries. It says average pay for nurses fell by 6% between 2011 and 2021 - once inflation is taken into account - compared with a 4.6% drop across the whole UK workforce. The start times and lengths of the walkouts vary between ambulance services, but all will last between 12 and 24 hours. The East of England will be the only service unaffected.
The RCN says this is compromising care, because it means the NHS is struggling to attract and retain nurses. Hospitals told to free up beds for ambulance strike
But the government in England pointed out this year's award is in line with what the independent NHS Pay Review Body recommended. NHS staff were also awarded a 3% rise last year in recognition of their work during the pandemic, while the rest of the public sector had a pay freeze. Watch Make Sense of Strikes on iPlayer and find out more about why people are striking and whether industrial action works.
What do the NHS strikes mean for patients?
Nurses
Life-preserving treatment must be provided. All nurses in intensive and emergency care are expected to work.
Anyone who is seriously ill or injured should still call 999, or 111 for non-urgent care.
Other services, such as some cancer treatments, may be partially staffed.
Routine care, such as knee and hip replacements, is likely to be badly affected.
It is possible that nurses could be pulled off picket lines to work if there are safety concerns.
Ambulance staff
The ambulance strikes will affect non-life threatening calls only. The government says the advice remains for people to call 999 in an emergency.
Hospitals have been warned by NHS bosses to prepare for "extensive disruption" and to free up beds to make it easier to move people through A&E and get paramedics quickly back on the road.
About 600 members of the armed forces are due to take on ambulance driving roles, and 150 personnel will provide logistical support.
Military to cover ambulance and border strikes
Watch this video quiz to test your knowledge of nurses' pay
Watch this video quiz to test your knowledge of nurses' pay
Why are nurses and ambulance staff striking?
Nurses
The Royal College of Nurses (RCN) says its members should have a 19% pay rise.
The government says this is unaffordable and no pay rise close to that has been offered:
NHS staff in England and Wales - including nurses - have already been given an average increase of 4.75%. The lowest paid were guaranteed a rise of at least £1,400
In Northern Ireland, nurses will receive the same increase, which will be backdated
In Scotland, a pay offer averaging 7.5% for NHS staff has been accepted by some unions. Others, including the RCN, are still considering it
The RCN says average pay for nurses has already fallen by 6% between 2011 and 2021, once inflation is taken into account.
The union says it will set a 48-hour deadline after the strike ends for the government to discuss pay.
If not, more action will be announced for the new year. The RCN has about 300,000 members - roughly two-thirds of NHS nurses.
Ambulance staff
They also want above-inflation pay rises, but have not set a specific figure.
Unions argue that any offer needs to he high enough to prevent an ambulance staff recruitment crisis. In Scotland, two unions have already accepted an improved pay offer of 7.5%.
The UK government, however, says pay rises for ambulance workers and nurses were decided by independent pay review bodies.
How much are nurses paid?How much are nurses paid?
The starting salary for a nurse is England is just over £27,000 a year. This is the bottom of pay band five of the NHS contract, known as Agenda for Change.The starting salary for a nurse is England is just over £27,000 a year. This is the bottom of pay band five of the NHS contract, known as Agenda for Change.
Staff such as healthcare assistants, porters and cleaners are on lower pay bands.Staff such as healthcare assistants, porters and cleaners are on lower pay bands.
Under the contract, staff are entitled to in-the-job salary increases within their pay band. Under the contract, staff are entitled to in-the-job increases within their pay band.
A nurse with four years' experience would be expected to get close to £33,000 - the top end of pay band five. A nurse with four years' experience could expect to earn close to £33,000 - the top end of pay band five.
Specialist nurses, such as those with extra qualifications to treat cancer and diabetes patients, can get up to £47,000. Specialist nurses can make up to £47,000.
The most senior nurse consultants can earn up to nearly £55,000.The most senior nurse consultants can earn up to nearly £55,000.
What does the nurses' strike mean for patients? What's the gap between public and private sector pay?
Under trade union laws life-preserving care has to be provided. Would pay demands cost an extra £28bn?
Therefore, all nursing staff would be expected to work in services such as intensive and emergency care.
Other services, such as cancer treatment or urgent testing, may be partially staffed.
Details will be negotiated by local service managers and union representatives.
It is also possible that nurses could be pulled off picket lines to work if there are safety concerns during a strike.
This happened during the 2019 walkout in Northern Ireland by RCN members - the only other time the union has been involved in strike action.
Routine services - including planned operations such as knee and hip replacements, community nursing services and health visiting - are expected to be badly affected.
Where is strike action taking place?
The walkout will involve RCN members in more than half of hospitals and community teams.
The strike ballot was sent to 300,000 RCN members - representing around two-thirds of the nurse workforce.
However, instead of one national ballot, a series of mini ballots were held across local services. This could be a hospital trust or community service, but not an individual GP practice.
Nurses in every service in Scotland and Northern Ireland voted for action. In Wales all but one health board did.
But in England, the turnout was too low in nearly half of NHS trusts for strike action to go ahead. At least 50% of union members need to take part in a strike ballot for it to count.
It is likely strike action will take place in all the services that voted yes, but the RCN has yet to formally notify each individual services. That is likely to be completed next week.