Picket lines are being set up at dozens of hospitals and thousands of NHS appointments and operations have been cancelled, with the health service running a bank holiday-style service in many areas.
The Royal College of Nursing (RCN) has said it will still staff chemotherapy, emergency cancer services, dialysis, critical care units, neonatal and paediatric intensive care.
Some areas of mental health and learning disability and autism services are also exempt from the strike, while trusts have been told they can request staffing for specific clinical needs.
When it comes to adult A&E and urgent care, nurses will work Christmas Day-style rotas.
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Saffron Cordery, interim chief executive of NHS Providers, said agency NHS trusts were “pulling out all the stops” to lessen the impact on patients.
She said: “But it’s inevitable that some operations or appointments will have to be rescheduled, and trusts are pulling out all the stops to minimise disruption.
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“The cold snap has ramped up demand that was already at or close to record levels, but on strike day NHS trusts will do everything they can to ensure that essential services are properly staffed and patient safety, always the number one priority, is safeguarded.”
RCN chief executive Pat Cullen has accused Health Secretary Steve Barclay of “belligerence” after he refused to discuss the issue of pay – because the government has already accepted recommendations made by the NHS Pay Review Body (PRB) to give below inflation pay rises of around 4%.
This would have seen them get a pay rise of around £1,400.
Image: Health Secretary Steve Barclay has been criticised by the head of the Royal College of Nursing
The RCN has been calling for a pay rise at 5% above inflation, though it has indicated it would accept a lower offer.
When it submitted the 5% figure to the independent pay review body in March, inflation was running at 7.5%.
But inflation has since soared, with RPI standing at 14.2% in September.
‘A tragic first’
Meanwhile, in Scotland, RCN members are being consulted on a revised pay offer from the Scottish government.
Ms Cullen said: “Nurses are not relishing this, we are acting with a very heavy heart.
“It has been a difficult decision taken by hundreds of thousands who begin to remove their labour in a bid to be heard, recognised and valued.
“It is a tragic first for nursing, the RCN and the NHS.
“Nursing staff on picket lines is a sign of failure on the part of governments.
“My plea to patients is to know that this strike is for you too – it’s about waiting lists, treatments that are cancelled year round and the very future of the NHS.”
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7:25
Royal College of Nursing leader Pat Cullen says the government’s ‘turned its back’ on nurses
The RCN has also raised the issue of huge staff vacancies in the NHS, with 47,000 nurse roles empty in England alone. And it has warned strike action may need to continue into January if the government does not re-negotiate on pay.
The health secretary said nurses were “incredibly dedicated to their job” and that it was “deeply regrettable some union members are going ahead with strike action”.
Mr Barclay added: “My number one priority is to keep patients safe – I’ve been working across government and with medics outside the public sector to ensure safe staffing levels – but I do remain concerned about the risk that strikes pose to patients.
“Nevertheless, the NHS is open and patients should continue to seek urgent medical care – and attend appointments – unless they’ve been contacted by the NHS.”
He said paying nurses more “would mean taking money away from frontline services at a time when we are tackling record waiting lists as a result of the pandemic.”
But pressure is mounting on the government to find a compromise on pay, with former Conservative Party chairman Sir Jake Berry saying it “is going to have to improve its offer”.
“We need to find a way as a government, and the union does too, to get to that centre point, that point of agreement straight away,” he told Talk TV.
During the strike, nurses will man picket lines at major NHS hospitals, including Guy’s and St Thomas NHS Foundation Trust in London, Addenbrookes Hospital in Cambridge and University Hospitals Birmingham NHS Foundation Trust.
Several trusts have already given details of cancelled outpatient appointments and planned treatments.
The Western Trust in Northern Ireland said it had “regrettably taken the decision to cancel some non-emergency services”, with 587 outpatient appointments postponed across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital.
The trust said there would also be reduced staffing in community nursing services including rapid response nursing, district nursing, community respiratory nursing and continence services.
Image: Pic: AP
In Wales, the Welsh government said non-urgent or routine appointments are likely to be postponed.
On Wednesday, the head of NHS Employers said “real concerns” remain about the level of cover nurses will provide for cancer patients during the strike.
In a letter to NHS leaders, Danny Mortimer said some aspects of talks with the RCN had been disappointing and warned that “unless the government indicates a willingness to negotiate on pay-related matters, further strike dates will be announced by the RCN for January 2023 and beyond”.
A second RCN nurse strike is set for 20 December, while thousands of ambulance workers will go on strike on 21 December.
The RCN has urged agency workers not to cover for striking staff.
Members of the Rail, Maritime and Transport union (RMT) began the first of two 48-hour strikes at Network Rail – and 14 train companies – on Tuesday, which will last until Friday.
There is also industrial action planned in a whole number of UK spheres, including paramedics,postal workers, Border Force agents, firefighters, driving instructors, bus operators, airport baggage handlers and even coffin makers.
Facing criticism for being on the back foot after a summer of protest outside asylum hotels, they were keen to defend their record and get back on track – but is it too late?
It’s a clear nod to the political void Reform UK has seized on while the prime minister has been on holiday.
Last week, Nigel Farage unveiled his party’s mass deportation policy – though the issue of women and children still seems to be worked out.
But perhaps none of that matters as voters overwhelmingly believe Reform cares about this issue – and as Chris Philp, the shadow home secretary, pointed out on Monday, voters have lost confidence in the government somewhat to solve what many see as an immigration crisis on their doorstep.
So it’s clear the strategy has changed from the government.
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‘Substantial reforms are needed now’
Gone are the bold slogans of “smashing the gangs” and instead, detail and policy was given on Monday. It was nothing new, but more substance on what the government has done and where they want to move to. Even controversially, reassessing their relationship with the European Convention on Human Rights (ECHR).
The biggest update though, was on their one-in-one-out policy agreement with France, which will now set to start returns later this month.
It’s finally hit home for the government that the public want proof not just rhetoric, and they want to know crucially when they will start to see change.
But the fightback, the reset, whatever the government wants to call it, will only make a difference once that finally starts to work.
Police are asking for help with an unsolved case, 52 years after the murder of a schoolboy in Belfast.
Brian McDermott was 10 when he disappeared from Ormeau Park on Sunday 2 September 1973. His remains were recovered from the River Lagan almost a week later.
Detectives from the Police Service of Northern Ireland’s Legacy Investigation Branch have given a timeline of events as part of their appeal.
Brian left his home on Well Street in the lower Woodstock Road area of east Belfast at around 12.30pm and failed to return for his Sunday dinner.
Detectives said he was last seen playing alone in the playground between 1pm and 3pm that afternoon.
His remains were recovered in the water, close to the Belfast Boat Club.
Image: River Lagan, where the remains of schoolboy Brian McDermott were recovered. Pic: PSNI handout/PA
A PSNI spokesperson said: “We are acutely aware of the pain and suffering that Brian’s family continue to feel, and our thoughts very much remain with the family at this time.
“Despite the passage of time, this murder case has never been closed and I am hopeful that someone may be able to provide information, no matter how small, which may open a new line of inquiry, or add a new dimension to information already available.
“It is also possible that someone who did not volunteer information at the time may be willing to speak with police now. Legacy Investigation Branch Detectives will consider all investigative opportunities as part of the review into Brian’s murder.”
The transfer window was a show of strength in a record-breaking summer across the Premier League.
The totaliser crept over £3bn in spending, with more than half of it flowing among the 20 clubs rather than having a redistributing effect across Europe.
The start of new Premier League TV deals – the biggest individual source of income being from Sky News’ parent company Comcast – provides certainty for the next four years, while rival leagues can struggle to sell rights.
And the feared threat from Saudi Arabia has not materialised. It is an attractive and lucrative destination for some players, but not yet the ultimate destination.
But the kingdom has still influenced this transfer window.
Image: Alexander Isak has joined Liverpool. Pic: Reuters
Let’s start with Newcastle, four years into their ownership by the Saudi sovereign wealth fund.
Having secured a return to the Champions League, bringing UEFA riches, this was the summer to grow rather than lose talent to rivals.
But the Premier League’s pecking order became clear when Alexander Isak pushed for a move to Liverpool and rejected bids that did not deter his ambitions.
Player power won out.
The 25-year-old striker was able to withdraw himself from the squad, miss the opening three matches of the season, and put out a statement claiming promises had been broken by the Magpies.
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Will Liverpool’s spend equal success?
Liverpool ‘loading up on talent’
And so he held on until deadline day, biding his time, sitting it out, and standing firm. Newcastle folded, accepting £125m – £20m lower than their apparent valuation.
Breaking the British record fee was Liverpool’s American ownership flexing financial muscle like never before.
The Premier League champions allowed manager Arne Slot to build from a position of strength.
This was the second time they broke the record in this window after bringing in another forward, Florian Wirtz, in a £116m deal.
More than £400m in reinforcements arrived at Anfield in a matter of weeks.
Former Liverpool managing director Christian Purslow told Sky Sports: “Liverpool are making hay while the sun shines, going for it. Really loading up on talent.
“Other clubs should be fearful and respectful of the way [Fenway Sports Group] are running their club.”
Image: Eberechi Eze (centre right), who left Palace for Arsenal this summer, celebrates winning the FA Cup final. Pic: PA
The Isak deal weakened their Champions League rivals from the North East after banking £57m from another club owned by the Public Investment Fund when Darwin Nunez was offloaded to Saudi.
And PIF funded Chelsea’s summer spending spree in less obvious ways.
The Blues did negotiate a £44m package with PIF-backed Al Nassr deal for Joao Felix, recouping the fee paid just a year earlier.
But then there was the £90m prize money collected for winning the new FIFA Club World Cup – a competition bankrolled by PIF subsidiaries.
Where does this leave Newcastle? Still spending around £250m.
Image: Florian Wirtz joined Liverpool from Bayer Leverkusen. Pic: AP
Players and Liverpool couldn’t get all their way this summer, with Marc Guehi forced to stay at Crystal Palace after the FA Cup winners failed to secure a replacement for the England centre-back.
The late drama was just the latest of the summer transfer window’s twists and turns.
Both Arsenal and Manchester United also spent more than £200m each. The Gunners spent big in pursuit of a title that’s eluded them since 2004, while the Red Devils are just trying to get back into the Champions League.
It added up to a new record total outlay that comfortably eclipsed the previous Premier League record of £2.46bn from 2023.
The £3bn is more than the rest of Europe combined, showing both where the power is in world football and why the Premier League is the one the world wants to watch.