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NHS workers could be offered a pay rise early next year in a bid to end further strike action – as unions and the government remain mired in a stalemate.

Health workers typically receive a backdated wage increase in the summer, even though recommendations are made by the independent Pay Review Body (PRB) in April.

Ministers have previously been criticised for delays to implementing the increase, with the trade union Unison accusing the government of “deliberately holding back” the PRB’s findings for months this year.

The Telegraph has reported that Steve Barclay, the health secretary, wants next year’s PRB process to be sped up so any extra money can be added to pay packets at the “earliest opportunity”.

While this does not mean a new or “fast-tracked” pay offer, a source close to the cabinet minister told Sky News political correspondent Ali Fortescue that he is “keen to get moving” with the process and doesn’t want it to be “bogged down” as it has been in the past.

The process of setting pay recommendations for next year is already under way.

The source said Mr Barclay is “willing to listen”, and there is an “opportunity in spring to assess if pay rises are affordable”.

More on Nhs

But Unison’s head of health Sara Gorton said: “Before embarking on the 2023 pay round, ministers need to accept they’ve not raised wages sufficiently to stop key staff from leaving the service this year.

“The pay review body process is no longer delivering for NHS staff or the government. Direct talks with ministers to solve wage issues are the way forward.”

Unions – which have been calling for inflation-busting pay rises – have said they expect NHS workers to be offered a 2% increase next year, based on a letter sent by Mr Barclay to the PRB last month.

It follows two days of historic strikes by nurses and ambulance workers, which senior health leaders have warned will have a “knock on effect” on appointments and emergency calls.

Matthew Taylor, chief executive of the NHS Confederation, told Sky News that the health service “coped as well as could be expected” during the strikes due to planning and the public making “less use of 999”.

But he warned that the NHS “can’t afford to drift into further industrial action across the winter” as he urged the government and trade unions to come to an agreement.

NHS ‘paying price’ for austerity

He said the NHS is “paying the price” for 10 years of austerity, the COVID backlog and not addressing workforce issues – as vacancies reach 130,000.

Mr Taylor said: “This winter is going to be incredibly tough, there’s nothing we can do about that. But the industrial action adds to what is already a challenging situation, which is why, on behalf of leaders in the NHS, I repeat the call to the government to re-enter negotiations in good faith with the trade unions and to try to find a way of avoiding further industrial action across the winter.”

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NHS facing ‘real pressure’ following strikes

Ministers have continually insisted pay negotiations are not up to them as the independent pay review bodies recommend what salary increases should be, and the government has accepted that.

This year, the PRB recommended a pay rise of £1,400 for most NHS staff – an average uplift of 4%.

The pay review bodies are made up of experts in their field without political affiliations who take evidence from a range of sources, including trade unions and staff.

Read more:
Strikes every day before Christmas – which sectors are affected and why
How A&E and other NHS services will be impacted

But last week, the GMB union – which represents tens of thousands of health workers – announced it was pulling out of the process used by the government to set NHS pay, as it questioned the independence of the PRB.

Some Tory MPs have also called on ministers to ask NHS pay reviewers to reconsider their recommendations as a way to end the strikes by offering higher rises.

The government has insisted higher pay offers are not affordable and the money would have to be taken out of frontline services.

There was no sign of the stalemate ending last night, as Unite general secretary Sharon Graham accused Mr Barclay of a “blatant lie” for saying ambulance unions had taken a “conscious decision” to inflict harm on patients.

Further ambulance strikes are planned next week, with unions threatening more action next year unless there are moves on pay talks.

Workers across several other industries are also set to strike in the build-up to Christmas.

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Even after US strikes, Iran may still have the ability to make a nuclear bomb

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Even after US strikes, Iran may still have the ability to make a nuclear bomb

It would be sensible to wait until the dust has settled before judging whether the US strikes on Iran were, in Donald Trump’s, words, “a spectacular military success”.

And when dropping bombs that weigh more than 13 tonnes each, there’s going to be a lot of dust.

The Pentagon says the operation against Iran’s three largest nuclear facilities involved 125 military aircraft, warships and submarines, including the largest operational strike by B2 bombers in history.

Follow latest: Iran considering ‘all options’ after US strikes

The B-2s dropped 14 of America’s most powerful GBU-57 “bunker buster” bombs on the Natanz uranium enrichment plant and Iran’s most sophisticated nuclear facility at Fordow.

The first time, according to the Pentagon, the weapons have been used in a military operation.

The Fordow complex, buried deep in a mountain, was the only site not previously damaged by Israeli strikes over the last few days.

A GBU-57, or the Massive Ordnance Penetrator bomb, at Whiteman Air Base in Missouri. in 2023. File pic: US Air Force via AP
Image:
A bunker-busting bomb. File pic: US Air Force via AP

The use of multiple GBU-57 bombs at Fordow is telling.

Despite their size, it was known that one of them would be insufficient to penetrate 80+ metres of solid rock believed to shelter Iran’s most sophisticated uranium enrichment technology deep within Fordow.

Read more:
Fordow: What we know about Iran’s secretive ‘nuclear mountain’
What we know so far about US strikes on Iran’s nuclear facilities

Satellite images reveal three visible holes at two different strike points on the mountainside above the complex.

A satellite image showing two clusters of holes at the Fordow nuclear site in Iran following US strikes on the facility. Pic: Maxar
Image:
A satellite image showing two clusters of holes at the Fordow nuclear site in Iran following US strikes on the facility. Pic: Maxar

The sites appear to be close to what may have been ventilation shafts – possibly chosen to maximise damage below and render the facility useless.

Using several of the bombs in the same location is likely designed to allow each to penetrate further than the first before detonating.

If nuclear facilities at Isfahan, Natanz and Fordow were destroyed – as the US claims – or even crippled, it would certainly halt Iran’s ability to enrich the Uranium needed to make a viable nuclear weapon.

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Clarke: The dust will need to settle before we know true impact of US strikes

But that’s not the same as preventing Iran’s ability to make a nuclear bomb. To do that, they need “weapons-grade” uranium; the necessary metal-shaping, explosives and timing technology needed to trigger nuclear fission in the bomb; and a mechanism for delivering it.

The facilities targeted in the US raid are dedicated to achieving the first objective. Taking naturally occurring uranium ore, which contains around 0.7% uranium 235 – the isotope needed for nuclear fission – and concentrating it.

The centrifuges you hear about are the tools needed to enrich U-235 to the 90% purity needed for a compact “implosion”-type warhead that can be delivered by a missile.

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Iranian media: ‘Part of Fordow’ attacked

And the reality is Iran’s centrifuges have been spinning for a long time.

United Nations nuclear inspectors warned in May that Iran had at least 408kg of uranium “enriched” to 60%.

Getting to that level represents 90% of the time and effort to get to 90% U-235. And those 400kg would yield enough of that weapons-grade uranium to make nine nuclear weapons, the inspectors concluded.

The second element is something Iran has also been working on for two decades.

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‘US strikes won’t end Iran’s nuclear programme’

Precisely shaping uranium metal and making shaped explosive charges to crush it in the right way to achieve “criticality”, the spark for the sub-atomic chain reaction that releases the terrifying energy in a nuclear explosion.

In its recent bombing campaign, Israel is thought to have targeted facilities where Iranian nuclear scientists were doing some of that work.

Analysis on the US strikes:
Trump’s two big gambles as US enters war with Iran

For Trump, the performative presidency just got real

But unlike the industrial processes needed to enrich uranium, these later steps can be carried out in laboratory-sized facilities. Easier to pack up and move, and easier to hide from prying eyes.

16 cargo trucks line up at the entrance of the Fordow nuclear site on 19 June. Pic: Maxar Technologies
Image:
16 cargo trucks line up at the entrance of the Fordow nuclear site on 19 June. Pic: Maxar Technologies

Given that it’s understood Iran already moved enriched uranium out of Fordow ahead of the US strike, it’s far from certain that Iran has, in fact, lost its ability to make a bomb.

And while the strikes may have delayed the logistics, it’s possible they’ve emboldened a threatened Iran to intensify its warhead-making capability if it does still have one.

Making a more compact implosion-based warhead is not easy. There is debate among experts about how advanced Iran is along that road.

But if it felt sufficiently motivated, it does have other, less sophisticated nuclear options.

Even 60% enriched uranium, of which – remember – it has a lot, can be coaxed to criticality in a much larger, cruder nuclear device.

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This wouldn’t pose as much threat to its enemies, as it would be too heavy to fit on even the best of Iran’s long-range missiles.

But it would, nonetheless, elevate Iran to the status of a nuclear power.

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Isfahan, Natanz and Fordow: What we know about Operation Midnight Hammer as US strikes Iran’s nuclear facilities

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Isfahan, Natanz and Fordow: What we know about Operation Midnight Hammer as US strikes Iran's nuclear facilities

Details are emerging about the US strikes against Iran’s nuclear facilities.

The US military has provided details about which sites have been hit and what military elements have been used, as President Donald Trump hailed the attack on social media.

From the number of bunker buster bombs dropped to where they hit, here’s what we know so far.

Follow latest: US bombers strike three Iranian nuclear sites

How did ‘Operation Midnight Hammer’ unfold?

The US’s most senior military official gave details of how the attack, named Operation Midnight Hammer, unfolded.

A U.S. Air Force B-2 Spirit bomber takes off from Andersen Air Force Base, Guam January 11, 2018. Picture taken January 11, 2018. U.S. Air F
Image:
A US Air Force B-2 Spirit bomber. File pic: Reuters

General Dan Caine, chairman of the US joint chiefs of staff, said that at midnight on Friday, a large “B-2 strike package of bombers” launched from the US, flying east across the Atlantic.

More on Iran

To maintain the element of surprise, some other bombers flew west into the Pacific.

During the 18-hour flight, the planes underwent multiple rounds of refuelling.

As the seven B-2 bombers entered Iran, the US deployed “several decoys”, according to Gen Caine, and a US submarine launched more than two dozen Tomahawk cruise missiles at the Isfahan nuclear site.

At around 6.40pm EST on Saturday, the first B-2 bomber dropped two GBU 57 Massive Ordnance Penetrator weapons, known as bunker buster bombs, on Fordow.

“The remaining bombers then hit their targets,” said Gen Caine, with 14 GBU-57s dropped in total.

Bunker buster bombs are designed to explode twice. Once to breach the ground surface, and again, once the bomb has burrowed down to a certain depth.

A satellite image showing two clusters of holes at the Fordow nuclear site in Iran following US strikes on the facility. Pic: Maxar
Image:
A satellite image showing two clusters of holes at the Fordow nuclear site in Iran following US strikes on the facility. Pic: Maxar

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Iran’s nuclear ambitions ‘obliterated’

Israel has bunker busters in its arsenal but does not have the much more powerful GBU-57, which can only be launched from the B-2 bomber and was believed to be the only bomb capable of breaching Fordow.

This attack was the GBU-57s’ first operational use.

A GBU-57, or the Massive Ordnance Penetrator bomb, at Whiteman Air Base in Missouri. in 2023. File pic: US Air Force via AP
Image:
A file picture of a GBU-57 bunker buster bomb, which was possibly used in the attack on Fordow. Pic: AP

More than 75 weapons were used in total, including 14 30,000lb GBU-57 bunker buster bombs, and 125 aircraft took part.

The New York Times reported a US official as saying a B-2 also dropped two of the GBU-57s on the Natanz nuclear site.

The B-2s were all heading back towards the US by 7.05pm (EST), Gen Caine added, and he said the US military were not aware of any shots fired at the American jets by Iranian aircraft or air defences on the ground.

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‘US strikes won’t end Iran’s nuclear programme’

Which sites were hit?

America says it has hit the three key locations in Iran’s nuclear programme.

The US attacked the Fordow, Natanz and Isfahan nuclear sites in Iran
Image:
The US attacked the Fordow, Natanz and Isfahan nuclear sites in Iran

They include Isfahan, the location of a significant research base, as well as uranium enrichment facilities at Natanz and Fordow.

Read more: Fordow: What we know about Iran’s secretive ‘nuclear mountain’

Natanz was believed to have been previously damaged in Israeli strikes after bombs disrupted power to the centrifuge hall, possibly destroying the machines indirectly.

Details about the damage in the US strikes are not yet known, although Mr Trump said the three sites had been “obliterated”.

The US secretary of defence Pete Hegseth said the US had “devastated the Iranian nuclear programme”.

However, most of the highly enriched uranium at the Fordow nuclear facility was moved to an undisclosed location ahead of the attack, a senior Iranian source told the Reuters news agency.

Personnel numbers were also reduced at the site, according to the report.

16 cargo trucks line up at the entrance of the Fordow nuclear site on 19 June. Pic: Maxar Technologies
Image:
16 cargo trucks line up at the entrance of the Fordow nuclear site on 19 June. Pic: Maxar Technologies

Satellite images from Fordow show cargo trucks lining up at the entrance of the nuclear site in recent days.

How has Iran responded so far?

Iran’s foreign minister Abbas Araghchi warned that the US strikes “will have everlasting consequences”, adding that his country “reserves all options” to retaliate.

“The events this morning are outrageous and will have everlasting consequences,” Mr Araghchi wrote on X. “Each and every member of the UN must be alarmed over this extremely dangerous, lawless and criminal behaviour.”

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Sirens in Israel as Iran retaliates

Iran has requested an emergency meeting of the UN Security Council to “maintain international peace and condemn the US strikes”, according to state media.

Read more:
What happens next is largely in Iran’s control

Multiple places in Israel have been hit by Iranian missiles in response.

Several explosions have been heard over Tel Aviv with Israeli media saying missiles have hit northern and central Israel, including in Haifa, Ness Ziona, Rishon LeZion and Tel Aviv.

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Destruction in Israel after Iranian strikes

Sixteen casualties were reported by the country’s emergency services.

Abbas Golroo, head of the Iranian parliament’s foreign policy committee, also said in a statement on social media Iran could pull out of efforts to limit the spread of nuclear technology and weapons, called the Treaty on the Non-Proliferation of Nuclear Weapons (NPT).

He cited Article 10 of the treaty, which states that an NPT member has “the right to withdraw from the treaty if it decides that extraordinary events have jeopardised the supreme interests of its country”.

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Bonus episode: Trump bombs Iran

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Bonus episode: Trump bombs Iran

👉Listen to The World with Richard Engel and Yalda Hakim on your podcast app👈

In this bonus episode, Richard and Yalda get together and talk about President Trump’s decision to strike three nuclear sites in Iran.

Yalda is in Jerusalem and Richard is in Tel Aviv where both of them have been reporting all night long.

Yalda reveals what her contacts are telling her about the extent of the damage done to the sites. They then ask, what could happen next?

To get in touch or to share questions, email theworld@sky.uk

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