The UK's largest nursing union is leading another strike in England on Monday demanding pay rises in the face of inflation, in a walkout that has been cut short by a court order. The Royal College of Nursing (RCN) has been engaged in industrial action since December, the union's first strike since it was founded more than a century ago. The latest walkout began on Sunday evening after RCN members rejected the government's latest proposals for a 5% pay rise and a one-off payment of at least £1,250 (€1,425). For the first time, the 28-hour strike will include nurses working in intensive care units and cancer wards, although exceptions are being made in hospitals where a lack of nurses could endanger patients' health. "Our nursing staff will be back in this morning, whilst on strike, continuing to care for their patients," RCN leader Pat Cullen told BBC Breakfast. All hospitals have been guaranteed a minimum level of cover for intensive care and trauma. A quarter of trusts involved in the strike have been given extra exemptions for services such as transplant and cardiac care - to allow them to call some striking nurses in because they have not been able to find other staff to fill the rotas. This is to ensure a minimal level of cover - not normal staffing - as the RCN has to abide by trade union rules to ensure life-and-limb care can be provided during a walkout. In previous walkouts services such as intensive care, chemotherapy and dialysis have been completely excluded from strike action This latest 28-hour action comes ahead of a crucial meeting between a number of health unions, ministers and NHS bosses on Tuesday, when the government's pay offer of 5% will be discussed. Ms Cullen denied suggestions there had been talks over the weekend with Health Secretary Steve Barclay or his department, and said it was "unfair to keep on saying that it is nursing staff who have created the seven million long waiting lists". "They [nurses] are selfless people, and they are standing up for their patients in an NHS that is totally broken," she said, adding that her union's members had taken six days' strike action in the past six months. The RCN previously rejected the government's pay offer and announced this new strike - their third this year - in a dispute over pay, recruitment and retention in the NHS. The health secretary described the RCN's decision to press ahead with its strike as "premature" and disrespectful to other unions taking part in Tuesday's meeting. Members of the Unite union at some NHS trusts and ambulance services in England are also taking part in strike action on Monday and Tuesday, after also voting to reject the latest pay offer. NHS England said the strike was the largest industrial action so far and warned patients to expect "disruptions and delays to services over the strike period". It warned that staffing levels for some areas would be "exceptionally low, lower than on previous strike days" and the number of rescheduled appointments as a result of strike action was due to hit half a million next week. Ministers and NHS chiefs had previously warned patient safety would be put at risk. On Sunday, Health Secretary Barclay said the strikes would put "more pressure on the NHS and will be incredibly disruptive for patients". Doctor Jacob Mushlin, an accident and emergency consultant at Bradford Royal Infirmary, said the absence of nurses would create delays and lower the standard of treatment at his hospital and across the country. "The nurses provide a vital service and one that can't be replaced by other members of staff," he said. "We're going to find that we're going to be unable to provide anything other than life or limb preserving care." Dr Mushlin also said he had seen a rising number of cases of "dreadful" aggression and violence towards hospital staff increasing because of long waiting times in the NHS, which was severely impacting morale. The walkout by RCN members started at 20:00 BST on Sunday and will end at midnight on Monday. It was originally supposed to continue into Tuesday but a High Court judge ruled it would be unlawful because a six-month mandate for action had expired. The strike was called earlier this month after RCN members rejected a government offer to nurses in England of a 5% pay rise for 2023-24 and a one-off payment of at least £1,655 to top up last year's salary, depending on staff grade. RCN leadership had recommended members accept the offer but it was rejected by 54% to 46%. During nursing strikes earlier this year, in January and February, wider national exemptions were in place, meaning nursing cover was maintained in other critical areas. On Monday, Unite members at the Yorkshire ambulance service and Guy's and St Thomas' NHS Trust in central London will walk out, and stage a protest march in central London. Then on Tuesday, Unite members at South Central, South East Coast and West Midlands ambulance trusts alongside workers at The Christie NHS Foundation Trust and Pathology Partnership, East Lancashire Hospitals NHS Trust and Sandwell and West Birmingham NHS Trust will all take part in industrial action. Unite national lead Onay Kasab told BBC Radio 4's Today programme that the union would continue industrial action if the health secretary attempted to impose a pay offer. "We will ballot, and where we have current mandates - some of them lasting up to September - then we will continue taking action, and we will escalate," he said. He said the ongoing disruption was "a national crisis" and urged Prime Minister Rishi Sunak to get involved to resolve it. — Agencies
