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.
More on Nhs
Related Topics:
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.
Advertisement
“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.
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.”
Please use Chrome browser for a more accessible video player
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.
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.
The UK is on a “slippery slope towards death on demand”, according to the justice secretary ahead of a historic Commons vote on assisted dying.
In a letter to her constituents, Shabana Mahmood said she was “profoundly concerned” about the legislation.
“Sadly, recent scandals – such as Hillsborough, infected blood and the Post Office Horizon – have reminded us that the state and those acting on its behalf are not always benign,” she wrote.
“I have always held the view that, for this reason, the state should serve a clear role. It should protect and preserve life, not take it away.
“The state should never offer death as a service.”
On 29 November, MPs will be asked to consider whether to legalise assisted dying, through Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill.
Details of the legislation were published last week, including confirmation the medicine that will end a patient’s life will need to be self-administered and people must be terminally ill and expected to die within six months.
Advertisement
Please use Chrome browser for a more accessible video player
14:46
Minister ‘leans’ to assisted dying bill
Ms Mahmood, however, said “predictions about life expectancy are often inaccurate”.
“Doctors can only predict a date of death, with any real certainty, in the final days of life,” she said. “The judgment as to who can and cannot be considered for assisted suicide will therefore be subjective and imprecise.”
Under the Labour MP’s proposals, two independent doctors must confirm a patient is eligible for assisted dying and a High Court judge must give their approval.
The bill will also include punishments of up to 14 years in prison for those who break the law, including coercing someone into ending their own life.
Please use Chrome browser for a more accessible video player
However, Ms Mahmood said she was concerned the legislation could “pressure” some into ending their lives.
“It cannot be overstated what a profound shift in our culture assisted suicide will herald,” she wrote.
“In my view, the greatest risk of all is the pressure the elderly, vulnerable, sick or disabled may place upon themselves.”
Labour MP Kim Leadbeater, who put forward the bill, said some of the points Ms Mahmood raised have been answered “in the the thorough drafting and presentation of the bill”.
“The strict eligibility criteria make it very clear that we are only talking about people who are already dying,” she said.
“That is why the bill is called the ‘Terminally Ill Adults (End of Life) Bill’; its scope cannot be changed and clearly does not include any other group of people.
“The bill would give dying people the autonomy, dignity and choice to shorten their death if they wish.”
In response to concerns Ms Mahmood raised about patients being coerced into choosing assisted death, Ms Leadbeater said she has consulted widely with doctors and judges.
“Those I have spoken to tell me that they are well equipped to ask the right questions to detect coercion and to ascertain a person’s genuine wishes. It is an integral part of their work,” she said.
In an increasingly fractious debate around the topic, multiple Labour MPs have voiced their concerns.
In a letter to ministers on 3 October, the Cabinet Secretary Simon Case confirmed “the prime minister has decided to set aside collective responsibility on the merits of this bill” and that the government would “therefore remain neutral on the passage of the bill and on the matter of assisted dying”.
She talks about a “slippery slope towards death on demand”. Savage. The state should “never offer death as a service”, she says. Chilling.
So much for Sir Keir Starmer attempting to cool the temperature in the row by urging cabinet ministers, whatever their view, to stop inflaming or attempting to influence the debate.
Ms Mahmood talks, as other opponents have, about pressure on the elderly, sick or disabled who feel they have “become too much of a burden to their family”.
Please use Chrome browser for a more accessible video player
2:41
Details of end of life bill released
She hits out at a “lack of legal safeguards” in the bill and pressure on someone into ending their life “by those acting with malign intent”.
Advertisement
Malign intent? Hey! That’s quite an assertion from a secretary of state for justice and lord chancellor who’s been urged by the PM to tone down her language.
It’s claimed that Sir Keir ticked off Wes Streeting, the health secretary, after he publicly opposed the bill and launched an analysis of the costs of implementing it.
Will the justice secretary now receive a reprimand from the boss? It’s a bit late for that. Critics will also claim Sir Keir’s dithering over the bill is to blame for cabinet ministers freelancing.
Shabana Mahmood is the first elected Muslim woman to hold a cabinet post. Elected to the Commons in 2010, she was also one of the first Muslim women MPs.
She told her constituents in her letter that it’s not only for religious reasons that she’s “profoundly concerned” about the legislation, but also because of what it would mean for the role of the state.
But of course, she’s not the only senior politician with religious convictions to speak out strongly against Kim Leadbeater’s bill this weekend.
Gordon Brown, son of the manse, who was strongly influenced by his father, a Church of Scotland minister, wrote about his opposition in a highly emotional article in The Guardian.
He spoke about the pain of losing his 10-day-old baby daughter Jennifer, born seven weeks prematurely and weighing just 2lb 4oz, in January 2002, after she suffered a brain haemorrhage on day four of her short life.
Mr Brown said that tragedy convinced him of the value and imperative of good end-of-life care, not the case for assisted dying. His powerful voice will strongly influence many Labour MPs.
And what of Kim Leadbeater? It’s looking increasingly as though she’s now being hung out to dry by the government, after initially being urged by the government to choose assisted dying after topping the private members bill ballot.
All of which will encourage Sir Keir’s critics to claim he looks weak. It is, or course, a private members bill and a free vote, which makes the outcome on Friday unpredictable.
But the dramatic interventions of the current lord chancellor and the former Labour prime minister are hugely significant, potentially decisive – and potentially embarrassing for a prime minister who appears to be losing control of the assisted dying debate.
Red Bull driver Max Verstappen has won the Formula One world title for a fourth straight year.
His victory was confirmed after finishing fifth at the Las Vegas Grand Prix. Mercedes’ George Russell won the race.
The 27-year-old Dutchman becomes just the sixth driver in Formula One history to win four titles or more, after outscoring Lando Norris who took the chequered flag in only sixth.
Verstappen is now guaranteed the world crown with two races still remaining, with his domination cementing his name among Formula One’s greats.
“Oh my God man,” said an emotional Verstappen after securing the world title. “What a season. Four times. It was a little bit more difficult than last year.”
Lewis Hamilton raced back from 10th to second place to complete an impressive one-two finish for Mercedes. Carlos Sainz finished third for Ferrari, one place ahead of his team-mate Charles Leclerc.
Russell’s third victory was the most dominant of his career so far, crossing the line 7.3 seconds clear of Hamilton.
More on Formula 1
Related Topics:
Michael Schumacher and Lewis Hamilton have each won a record seven, with 1950s Argentine legend Juan-Manuel Fangio on five ahead of Alain Prost, Sebastian Vettel and now Verstappen on four.
Having won every Drivers’ Championship since claiming his first in the controversial end to the 2021 season when he beat Hamilton in deeply contentious circumstances, Verstappen now joins Hamilton, Fangio and Vettel in winning four titles consecutively.
Advertisement
Only Schumacher has achieved a run of five.
The team were hit by controversy earlier this season, with Red Bull’s principal sponsor, Christian Horner, facing allegations of controlling behaviour by a female staff member. Horner, who denied the accusations, was cleared, and a subsequent appeal was thrown out.
Horner congratulated Verstappen on the radio, telling him: “Max Verstappen you are a four-time world champion. That is a phenomenal, phenomenal achievement. You can be incredibly proud of yourself.”
Red Bull is on course to finish third in the constructors’ championship this year. This century only Hamilton in 2008 with McLaren, and Verstappen in 2021, have won the drivers’ title when their team did not win the constructors’ championship.