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What happens when nurses go on strike?

All nurses, including those in critical roles, will take strike action on March 1 in a serious escalation of the dispute with the government over pay

nurse portrait

The NHS is yet to face a national nursing strike. Image: Luke Jones

All nurses in England who are members of the Royal College of Nursing, including those in A&E and intensive care units, are set to stage a 48-hour strike from Wednesday March 1.

This marks a serious escalation in the dispute which has been running since December, when the RCN called its first national strike in its 106 year history.

Whereas previous strike dates saw some of the most critical services at NHS hospitals exempt from the action, the RCN has said that on March 1 there will be “no wide-ranging derogations in place”.

“It is with a heavy heart that I have today asked even more nursing staff to join this dispute,” said RCN general secretary Pat Cullen.

“These strikes will not just run for longer and involve more people but will leave no area of the NHS unaffected. Patients and nurses alike did not want this to happen.”

Cullen said that she would do “whatever I can to ensure patient safety is protected” but that by refusing to negotiate with nurses, prime minister Rishi Sunak is “pushing even more people into the strike”.

Here’s what you can expect when nurses take strike action in March.

When are nurses going on strike?

Nurses, including those in A&E and intensive care units, start a 48-hour continuous strike on the morning of Wednesday March 1.

Click here to see the full list of all the NHS trusts where nurses will go on strike in England

Why are nurses going on strike?

Britain’s nurses are facing a workforce crisis. The number of nurses and midwives quitting their jobs has risen for the first time in four years – suggesting conditions are even worse than during the pandemic. On average, 500 nurses are leaving every week. 

Severely understaffed wards are not only causing extreme stress and burnout, says the RCN, but are impacting the safety of patients and the quality of the treatment they can receive. 

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The RCN is seeking a pay rise of 5 per cent above inflation – which is currently at 10.1 per cent – to make up for what it calls a decade of real-terms pay cuts.

Only with higher pay will the sector be able to retain and attract new nurses, the union says, with two-thirds of nurses working in general practice thinking about leaving the profession within a year because of low pay.

What impact will the nurse strike have on health services?

This next set of strike action “will be very different and it’s clearly a much higher risk” East Suffolk and North Essex NHS Foundation Trust chief executive Nick Hulme told BBC Radio 4’s Today programme, adding there is “significant risk”.

The strike action will force health services to be ”reduced to an absolute minimum” said the RCN. It will cause disruption to planned appointments and procedures, and will lengthen backlogs and waiting lists.

“It is always the employer’s responsibility to ensure life-preserving services, so we expect life-preserving care to be provided by members of the wider workforce and other clinical professions”, a spokesperson wrote on the RCN website. 

A former Tory health minister, Lord Bethell, has warned the strikes could lead to increased deaths and delays in people being diagnosed.

During previous NHS strike action, the government brought in the military to help with running NHS services.

Studies have shown that short-staffing, whether caused by strike action or workforce crisis, has a “profound effect on nurses’ ability to do their jobs, increases rates of medical error and leads to preventable patient deaths”. 

A spokesperson for the Department of Health and Social Care said they hoped nurses would carefully consider the impact any strike action would have on patients.

“We value the hard work of NHS nurses and are working hard to support them,” the spokesperson said. The government increased the basic pay for newly qualified nurses by 5.5 per cent earlier this year, however most nurses received a rise of around 3.7 per cent. 

How do we know people won’t die as a result of strike action?

It is a legal requirement under Trade Union and Labour Relations 1992 to make sure that strike action does not endanger human life or cause serious injury – it is a criminal offence to strike if there is a risk of this happening.

Emergency treatment by nurses will always be maintained, the RCN told The Big Issue. A team will review minimal staffing levels at every health trust facing strike action to make sure there are always enough nurses working to maintain patient safety. 

If a major emergency were to happen that would require more nursing staff, nurses would be taken off picket lines and return to work, explained an RNC spokesperson. 

There are different ways of managing a nursing strike. Trusts may choose to implement a “Sunday service” or Christmas Day service or make certain essential services – such as intensive care – exempt from strike action. 

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Have nurses ever gone on strike in the UK before?

There has never been a national nursing strike in the UK, but a total of 15,000 nursing staff went on strike in Northern Ireland in December 2019 over what they said were unsafe staffing levels and pay disparity.

The Health and Social Care Board reported at least 4,749 hospital appointments were cancelled and every aspect of health and social care had been affected.

Speaking on BBC Radio Ulster during the strike, Paul Cummings of the Health and Social Care Board said there had been “no reported issues of patient safety”.

The strike led to government reform and saw nurses given pay parity and a promise of safe staffing, Nursing Times has reported. 

“I never would have thought back in 1985, when I started nursing, that I would end up on a picket line,” said Jill Fleming, who took part in the strike. “It really goes against our grain. We’re our patients’ advocates. But that’s why we had to act – to fight for patient safety. There was huge support from patients, and that shows they understood that we did it in their interests.”

“Look at the experience of the college leading the first strike in Northern Ireland in 103 years,” said Cullen. 

“They did that very safely, they did that effectively, but they did it with a very steady hand. Throughout that action when nursing staff were standing on picket lines they didn’t abandon their patients.”

The Big Issue is calling on the government to fix the current crisis and make sure future generations are protected. We have three demands: ensure decent homes for all, end the low-wage economy, and create millions of green, well-paid jobs.

Sign our open letter and join the campaign for a better future.

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