What happens when nurses go on strike?

The Royal College of Nursing has guaranteed patient safety will be maintained should nurses go on strike

Nurses in England, Wales and Northern Ireland are set to go on strike on Thursday December 15 and Tuesday December 20. This will be the first time the Royal College of Nursing has called a national strike in its 106 year history. 

Many of the UK’s more than 200 NHS Trusts will be affected by strike action as nurses walk out over low pay, understaffing and patient safety concerns.

All NHS Trusts in Scotland and Northern Ireland will see strikes having met the threshold for walkouts and all bar one in Wales. 

One of London’s largest hospitals, St Thomas’ Hospital, which sits opposite the House of Commons, will see strike action, as well as the Royal Infirmary of Edinburgh, University Hospital of Wales in Cardiff and Royal Victoria Hospital in Belfast. 

Here’s what could happen if British nurses go on a national strike for the first time in history.

Are nurses still going on strike?

Yes, the national nursing strike is still set to go ahead after last-minute negotiations between the government and the RCN ended with no agreement.


The leader of the RCN, Pat Cullen, told The Observer that she had told health secretary Steve Barclay that she would be willing to press pause on the strike if the government returned to the negotiating table over pay. 

The RCN said it would seriously consider deals similar to those that have already led to NHS strikes being suspended in Scotland, where nurses in Unite and Unison accepted an offer of 7.5 to 11.2 per cent depending on pay grade. 

However Barclay refused to discuss pay, leaving the union to press ahead with the industrial action.

“I needed to come out of this meeting with something serious to show nurses why they should not strike this week. Regrettably, they are not getting an extra penny”, said Cullen.

Barclay said he would “continue to engage with the RCN as we move into the pay review process for next year and on non-pay related issues”. 

Click here to see the full list of all the NHS trusts where nurses will go on strike in England, Wales and Northern Ireland

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 10.71 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 would a nurses strike have on health services?

The government is planning to get the military to help with running NHS services during both the nursing and paramedics strikes.  

Health minister Will Quince also said that taxis may be enlisted to get low-risk patients to hospitals when ambulances are unavailable. He told MPs: “We are looking at ways we can provide additional support for category three and category four, including things like block-booking taxis and support through community healthcare and local authority fall services and community support.”

The strike will  cause disruption to planned appointments and procedures, the RCN has said. This would likely lengthen backlogs and waiting lists. There would, however, be measures in place to ensure patient safety is not at risk.

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.”

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