Nursing union tells agency workers NOT to cover unprecedented NHS strikes

Britain’s nursing union has urged agency nurses who may be called in to cover strike action not to cross the picket line.

This is despite the Government passing a new law allowing temporary skilled workers to cover industrial action earlier this year. 

The Royal College of Nursing (RCN) is due to publish the results of its ballot on strike action later this week, but a large majority are understood to have voted in favour of the strike. It is the first time the RCN has balloted 300,000 members for strike action in its 106-year history. 

It could lead to unprecedented NHS strikes that will leave patients only receive a ‘bank holiday’ level of service this winter.

And the RCN has asked agency nursing, who could be drafted in to help shore up staffing numbers to stop appointments being cancelled, not to cover positions left vacant by striking staff.

‘If you’re an agency worker allocated to work at an NHS organisation on a day of strike action, we at the RCN expect that you do not cover that shift,’ the union’s guidance reads. 

‘Agency workers should not provide cover for striking workers. If you’re an agency worker allocated to work at an NHS organisation on a day of strike action, we at the RCN recommend that you do not cover that shift.’ 

The union’s guidance conflicts with Government efforts to help stop union disruption of essential services.

In July this year the Government brought in a new law allowing for the hire of agency workers to cover industrial action to stop essential services being disrupted.

This was in response to the repeated strike action from transport unions bringing Britain’s rail network to a standstill. 

At the time, then Business Secretary Kwasi Kwarteng said: ‘In light of militant trade union action threatening to bring vital public services to a standstill, we have moved at speed to repeal these burdensome,1970s – style restrictions.’

‘From today, businesses exposed to disruption caused by strike action will be able to tap into skilled, temporary workers to provide the services that allow honest, hardworking people to get on with their lives. That’s good news for our society and for our economy.’ 

Hiring agency workers to cover striking NHS staff, could mean vital cancer and kidney disease treatments and routine operations could go ahead despite thousands of staff walking out over pay.

The RCN is demanding nurses receive a cost-of-living pay rise of 5 per cent above inflation, which currently sits at 12.3 per cent. This would grant the average nurse, who earns roughly £35,600 each year, an extra £6,150 annually.

Senior health sources said the NHS will operate as if it is Christmas Day on all strike days, with elective treatments scrapped — though emergency care will go ahead.

They also warned the action may exacerbate the bed-blocking crisis, as hospitals often fail to discharge patients who are ready to go home on bank holidays.

Strikes are expected to pile even more pressure on to the health service at its hardest time of year, as it battles winter pressures and expected waves of Covid and flu.

And it may worsen the backlog of care that has already piled up, with seven million people in England on the waiting list for elective hospital treatment by August. 

Nurses could end up firing the starting gun of a winter of discontent in the health service, with junior doctors, midwives and paramedics also mulling industrial action.

However, the RCN said nurses have been ‘forced’ into strike action due to a ‘decade of real-terms pay cuts’, warning ‘enough is enough’. 

A health official told The Daily Telegraph: ‘The understanding we have… is that they will commit to delivering a bank holiday level of service.

‘On bank holidays we don’t do elective work, but we do do emergency work.

‘Outpatient surgery, day surgery, chemo, dialysis… some of the things we have for discharging, transferring care, of patients [which] wouldn’t always happen on a bank holiday… it’s those kinds of services [which will be disrupted].’

The RCN balloted nurses at 300 NHS hospitals and trusts. 

However, not all 300 hospitals and trusts may be hit by strike action. 

At least half of nurses at each NHS organisation and trust need to vote in favour of industrial action for the strike to go ahead, which could trigger varying levels of service across the country. 

The senior health chief told the newspaper: ‘You might well have Nottingham that is on strike, and Derby isn’t. 

‘Derby would be providing a normal service but Nottingham would only be providing bank holiday and anything extra that they might agree to do locally,’ the source said. 

It is unclear when strikes will happen and how long they will last.

Like other workers, nurses can’t legally be sacked if they participate in official and lawful industrial action.

However, unlike other sectors, some nursing staff will continue to work. 

This is carefully negotiated with NHS bosses before the strike takes place to ensure patient safety.

For example, an entire service — such as an intensive care unit or night duty — may be exempt from the industrial action and continue working.

However, the walkout will involve theatre nurses, who play a major role in operations. 

That is likely to cause delays and cancellations for important planned procedures such as hip and knee replacements, leaving patients already hit by the Covid backlog waiting in pain for longer.  

Cabinet minister Oliver Dowden said the Department of Health had ‘contingencies’ in place for a strike and would prioritise the most essential services.

He told Sky News’ Sophy Ridge on Sunday programme: ‘I would continue to urge nurses and others to resist going out on strike, even if they have voted to do so.

‘We have already agreed quite considerable support for nurses.

‘Of course, if you are in the situation where you have a large number of nurses going out on strike, of course that is going to have an impact, for example on some elective surgery and other activities.’

The RCN is calling for a pay deal for its members employed by the NHS of 5 per cent above inflation, which is a total rise of around 17 per cent.

The amount offered to nurses in England and Wales by the Government, on the advice of the independent NHS Pay Review Body, is 3 per cent, or 4 per cent for an experienced nurse. 

This is on top of a 3 per cent pay rise in 2021, when wider public sector pay was frozen. 

There have been reports of nurses using food banks, struggling to afford to travel to work, or quitting the NHS for better paid jobs in shops and hospitality.

The NHS staffing crisis is also fuelling the strike action, with eight in ten nurses warning that there are too few medics to treat patients safely and effectively. 

The RCN said there are ‘record’ nursing vacancies and 25,000 nurses left the Nursing and Midwifery Council register. 

It is calling for more staff to reduce record waiting lists which have built up during the pandemic. 

Pat Cullen, the RCN’s general secretary and chief executive, said: ‘I want to thank members for taking the time to vote in this historic ballot.

‘Your vote is your voice, and we must use that voice. 

‘There has never been a more crucial time to fight for safe staffing and fair pay. Our NHS is on the precipice due to chronic staff shortages. 

‘Our profession is being pushed to the edge, with patient safety paying the price. 

‘None of us wants to take industrial action but we’ve been forced into this position after a decade of real-terms pay cuts. We can’t stand by and watch our colleagues and patients suffer anymore. Enough is enough.’ 

The RCN handbook says provision during the strike period should be equal to that on Christmas Day.

It did not allow strikes up until 1995, when it changed the rules to allow action so long as it was not detrimental to patients. 

A spokesman for the Department of Health and Social Care said: ‘We value the hard work of NHS staff including nurses and are working hard to support them – including by giving over one million NHS workers a pay rise of at least £1,400.’

The nurses’ strike could kickstart similar walkouts across the medical profession, with junior doctors, midwives and paramedics also mulling strikes.

The Royal College of Midwives has asked its 50,000 members to vote in support of industrial action when ballots open on November 11. 

Two-thirds have already said they would be willing to strike in a preliminary poll. 

More than 15,000 ambulance workers at 11 trusts in England and Wales are being balloted on industrial action over pay and ‘unsafe’ working conditions. 

The GMB union said if the strikes went ahead, which could take place ahead of Christmas, it would be the biggest for three decades. 

Some 8,000 members in Scotland last week voted ‘overwhelmingly’ in favour of industrial action. 

And the Chartered Society of Physiotherapy said more than eight in 10 of its 60,000 members across the UK are prepared to strike.

Members in Scotland last week voted in favour of strike action. Voting in England closes today, while members in Wales have until December 12 to post their ballot.

It makes the first time members have been balloted over pay in the CSP’s 100-year history. 

Meanwhile, the British Medical Association will ballot junior doctors in early January on whether it should strike over pay.

The BMA said it is ‘deeply concerned’ that continuing pay erosion will drive doctors out of the profession at a time of record backlogs and when the NHS ‘can least stand to lose them’. 

Discontent with pay and working pressures amid the cost of living crisis has seen rail workers strike for months and university staff set to strike.

Leanne Lewis, a nurse in Bridgend, Wales, who voted in favour of industrial action, said it was ‘an extremely difficult decision’.

Ms Lewis told BBC Radio Wales Breakfast programme: ‘I felt we needed to take action. Enough is enough.’

She said the NHS is ‘haemorrhaging staff’ and many are not working due to ‘burnout’ and ‘post-pandemic’ complications. Ms Lewis herself is off work and receiving half her pay due to long Covid. 

The situation means there are too few medics working on wards, creating ‘not safe’ staffing levels.

Ms Lewis said: ‘Nurses are absolutely traumatised and fed up of not being able to give the patient care they want to give and that they deserve.

‘It’s heart-breaking to have colleagues phoning me after a shift in tears because they feel they haven’t been able to provide the care they wish they could have due to not having the staff.

‘Staff are leaving the NHS and they’re going back into hospitals working on agency doing exactly the same role for sometimes double, quadruple the amount of wages purely because that’s the only way they can make ends meet.’

Ms Lewis said more needed to be done to encourage more people into the profession.

She said: ‘When I trained I had a small bursary of about £3,500 a year and the actual training was free. 

‘Nurses are having to pay now for their training through student loans.

‘They’re paying their day-to-day bills, travel expenses. There needs to some sort of compromise around pay and staffing numbers.

‘The Government needs to sit down with the RCA and other unions and have some serious discussions.’