Why are nurses striking, how will the walkout impact patients, and which hospitals are affected?

Nurses across England, Wales and Northern Ireland staging the first national walkout on Thursday in a dispute over pay and understaffing.

Here's a breakdown on why nurses are striking, how that could affect patients and which hospitals are taking part.

– Why are nurses striking?

The Royal College of Nursing (RCN) balloted its members over industrial action in a dispute over pay.

The union has argued that low pay is driving “chronic understaffing” which puts patients at risk and leaves nursing staff overworked, underpaid and undervalued.

– Is there really a crisis in the workforce?

Yes. While the number of nurses and midwives registered to work in the UK has grown to a record level – some 771,445 were on the Nursing and Midwifery Council register in September, separate figures from NHS Digital show there were a record 47,496 full-time equivalent nursing vacancies in England at the end of September.

This represents a vacancy rate of 11.9%.

– How many nurses will be on strike?

Tens of thousands of nurses are taking part in the walk out.

Originally it was anticipated that up to 100,000 would strike but this figure changed due to the various “derogations” which have occurred in recent weeks where nurses have agreed to provide certain services during strike days.

– When will the strikes take place?

The first strike is scheduled for Thursday December 15 with a second to follow on Tuesday December 20,

Not all organisations taking part are participating on both days.

– What happens if I’m sick?

People who need emergency or urgent care will still get help.

The strikes will affect other elements of care but people will have been contacted in advance to be told of changes to pre-planned care and encouraged to attend appointments unless they have been instructed otherwise.

GP surgeries and pharmacies will be running as normal.

– What has the Royal College of Nursing asked for?

The RCN has been calling for a pay rise at 5% above inflation, though it has indicated it would accept a lower offer.

When it submitted the 5% figure to the independent pay review body in March, inflation was running at 7.5%.

But inflation has since soared, with RPI standing at 14.2% in September - which is where the often repeated 19% rise figure the government say nurses are asking for comes from.

But the RCN has not specifically asked for a 19.2% pay uplift.

RCN chief executive Pat Cullen said nurses were asking for "20% that has been taken out of their pay over the last decade to be put back in".

– So what has been offered?

The independent Pay Review Body recommended that the majority of NHS staff on the so-called Agenda for Change contracts are to be given a £1,400 uplift in pay.

The Nuffield Trust has estimated that this is the equivalent to an average of 4.3% rise for qualified nurses.

The RCN has previously said that despite this year’s pay award, experienced nurses are worse off by 20% in real terms due to successive below-inflation awards since 2010.

– What has the government said?

The government accepted the recommendation by the pay review body and insists union demands are “not affordable” in the current economic climate.

They say that each additional 1% pay rise for all staff on the Agenda for Change contract would cost around £700 million a year.

Although the Pay Review Body estimates that each 1% increase in pay adds around £500.5 million to the Agenda for Change pay bill in England, £29.5 million in Northern Ireland and £37.5 million in Wales.

The Department of Health and Social Care said that using October’s RPI inflation data, a 5% above inflation rise would equate to a pay rise of 19.2%.

It said that uplifting pay for all staff on the Agenda for Change contract – which also includes staff such as midwives, ambulance workers, porters and cleaners – by 19.2%, instead of the existing pay award, would cost “around an additional £10 billion”.

Officials have said that this would hamper the NHS’s efforts in tackling the record backlog of care.

A separate pay offer has been made in Scotland.

– What has the NHS said:

Officials in England have said that they would like to see a resolution to the dispute as soon as possible “but pay is a matter for the government and the trade unions”.

– Where will the strikes take place?

Not every hospital will be affected by strike action. Here is the official list of trusts and NHS organisations taking part, released by the RCN.

• England

East Midlands

– Kettering General Hospital NHS Foundation Trust

– NHS Nottingham and Nottinghamshire ICB

– Northamptonshire Healthcare NHS Foundation Trust

– Nottingham University Hospitals NHS Trust

– Nottinghamshire Healthcare NHS Foundation Trust

Eastern

– Cambridge University Hospital NHS Foundation Trust

– Cambridgeshire and Peterborough NHS Foundation Trust

– Cambridgeshire Community Services NHS Trust

– Hertfordshire Community NHS Trust

– NHS Hertfordshire and West Essex ICB

– Royal Papworth Hospital NHS Foundation Trust

London

– Great Ormond Street Hospital for Children NHS Foundation Trust

– Guys and St Thomas' NHS Foundation Trust

– Imperial College Healthcare NHS Trust

– NHS North Central London ICB

– Royal Marsden NHS Foundation Trust

North West

– Alder Hey Children’s NHS Foundation Trust

– Liverpool Heart and Chest Hospital NHS Found Trust

– Liverpool University Hospitals NHS Foundation Trust

– Liverpool Women’s NHS Foundation Trust

– Mersey Care NHS Foundation Trust

– The Clatterbridge Cancer Centre NHS Found Trust

– The Walton Centre NHS Foundation Trust

Northern

– Gateshead Health NHS Foundation Trust

– Northumbria Healthcare NHS Foundation Trust

– The Newcastle Upon Tyne Hospitals NHS Foundation Trust

South East

– Oxford Health NHS Foundation Trust

– Oxford University Hospitals NHS Foundation Trust

– Royal Berkshire NHS Foundation Trust

South West

– Devon Partnership NHS Trust

– Gloucestershire Health and Care NHS Foundation Trust

– Gloucestershire Hospitals NHS Foundation Trust

– Great Western Hospitals NHS Foundation Trust

– NHS Bath, North East Somerset, Swindon and Wiltshire ICB (BSW Together)

– NHS Devon ICB (One Devon)

– NHS Gloucestershire ICB (One Gloucestershire)

– North Bristol NHS Trust

– Royal Devon University Healthcare NHS Foundation Trust

– Royal United Hospitals Bath NHS Foundation Trust

– Torbay and South Devon NHS Foundation Trust

– University Hospitals Bristol and Weston NHS Foundation Trust

– University Hospitals Plymouth NHS Trust

West Midlands

– Birmingham Women’s and Children’s NHS Foundation Trust

– Herefordshire and Worcestershire Health and Care NHS Trust

– NHS Birmingham and Solihull ICB (BSol ICB)

– The Royal Orthopaedic Hospital NHS Foundation Trust

– University Hospitals Birmingham NHS Foundation Trust

– Worcestershire Acute Hospitals NHS Trust

Yorkshire & Humber

– Bradford Teaching Hospitals NHS Foundation Trust

– Leeds Community Healthcare NHS Trust

– The Leeds Teaching Hospitals NHS Trust

National employers

– Health Education England

– NHS England

• Northern Ireland

– Belfast Health and Social Care Trust

– Northern Health and Social Care Trust

– Western Health and Social Care Trust

– Southern Health and Social Care Trust

– South Eastern Health and Social Care Trust

– Northern Ireland Practice and Education Council

– Business Services Organisation

– Regulation and Quality Improvement Authority

– Northern Ireland Blood Transfusion Service

– Public Health Agency

– Northern Ireland Ambulance Service

• Wales

– Cardiff and Vale University Health Board

– Powys Teaching Local Health Board

– Welsh Ambulance Services NHS Trust Headquarters

– Hywel Dda University Health Board

– Swansea Bay University Health Board

– Cwm Taf Morgannwg University Health Board

– Betsi Cadwaladr University Local Health Board

– Velindre NHS Trust

– Public Health Wales

– Health Education and Improvement Wales Health Authority

– NHS Wales Shared Services Partnership

– Digital Health and Care Wales

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