RCN nurses vote to reject latest government pay offer and plan to escalate strike action

Rishi Sunak claimed to have made a breakthrough in negotiations with nurses - so what happened? Deputy Political Editor Anushka Asthana breaks down the dispute

Nurses from the UK's largest union have voted to reject a government pay offer and plan to stage further strikes with staff from intensive care, emergency departments and cancer wards.

Members of the Royal College of Nursing (RCN) had until 9am on Friday to cast their vote, with 54% choosing to reject the latest offer and escalate their walkouts, as reported by ITV News on Thursday.

The government said on Friday the result will be "hugely concerning" for patients.

It comes as paramedics and other NHS workers from Unison voted overwhelmingly to accept the offer, which includes a one-off payment of around £2,500 and a 5% salary increase in 2023/24.

The Society of Radiographers has also announced its members rejected the same pay offer, and will ballot its members on strike action.

Writing to the Health Secretary Steve Barclay, the RCN's General Secretary and Chief Executive, Pat Cullen, said: “What has been offered to date is simply not enough.

"The government needs to increase what has already been offered and we will be highly critical of any move to reduce it."

The union has announced it now plans to strike from 8pm on April 30 until 8pm on May 2.

Speaking to broadcasters, Ms Cullen said: "Now it's about ensuring that this government gets this message loud and clear. We can avert the strike action we've planned for April by putting a realistic and meaningful offer on the table, not one that they put on and take off the following month."

"Let's start to get down and talk about that," she added.

'We need to add to that offer that's already there', said RCN General Secretary and Chief Executive, Pat Cullen

For the first time since beginning industrial action last year, the walkout will involve nursing staff from emergency departments, intensive care units, cancer care, and any other units that were previously exempt.

ITV News has previously reported that the UK's largest nursing union had threatened to escalate strike action in the long-running dispute over pay.

The union has also threatened to re-ballot its members in May, for further strike action across another six-month period.

Responding to the result, a spokesperson from the Department of Health and Social Care said: "It is hugely disappointing that the Royal College of Nursing membership has rejected the pay deal recommended by their leadership.

"Following constructive discussions, all parties agreed this was a fair and generous offer which is demonstrated by Unison, representing the largest share of the NHS workforce, choosing to accept it.

"The fact that the Royal College of Nursing has announced an escalation in strike action with no derogations, based on a vote from the minority of the nursing workforce, will be hugely concerning for patients.

"Hundreds of thousands of Agenda for Change staff continue to vote in ballots for other unions over the next two weeks and we hope this generous offer secures their support."

Meanwhile, the head of Unison said while "health workers would have wanted more", the government's most recent offer "was the best that could be achieved".

A government spokesperson said: "The decision by members of Unison, the largest NHS union, to accept the pay offer recommended by their leadership demonstrates that it is a fair and reasonable proposal that can bring this dispute to an end.

“Under the offer, an Agenda for Change employee at the Band 6 entry point – such as a physiotherapist, paramedic or a midwife – will receive over £5,100 across last year and this year, with over £2,000 in bonus payments arriving as a lump sum in pay cheques by summer."

The votes by nurses and other health workers took place as junior doctors staged their fourth day of strike action across the country - also in a bitter pay dispute with the government.

It's estimated that around 350,000 appointments and operations have been cancelled as a result of the walkout by British Medical Association (BMA) members.

Which locations will be impacted by the new nursing strikes?

East Midlands Derbyshire Community Health Services NHS Foundation Trust Derbyshire Healthcare NHS Foundation Trust East Midlands Ambulance Service NHS Trust Kettering General Hospital NHS Foundation Trust NHS Derby and Derbyshire ICB 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 East Suffolk and North Essex NHS Foundation Trust Hertfordshire Community NHS Trust NHS Hertfordshire and West Essex ICB NHS Mid and South Essex ICB NHS Norfolk and Waveney ICB NHS Suffolk and North East Essex ICB Norfolk and Norwich University Hospitals NHS Foundation Trust Norfolk and Suffolk NHS Foundation Trust Norfolk Community Health and Care NHS Trust Royal Papworth Hospital NHS Foundation Trust West Suffolk NHS Foundation Trust

London Great Ormond Street Hospital for Children NHS Foundation Trust Guys and St Thomas NHS Foundation Trust Hounslow and Richmond Community Healthcare NHS Trust Imperial College Healthcare NHS Trust Kings College Hospital NHS Foundation Trust NHS North Central London ICB NHS South West London ICB Royal Marsden NHS Foundation Trust St George’s University Hospitals NHS Foundation Trust Tavistock and Portman NHS Foundation Trust University College London Hospitals NHS Foundation Trust North West Alder Hey Children’s NHS Foundation Trust Bridgewater Community Healthcare NHS Foundation Trust Cheshire and Wirral Partnership NHS Foundation Trust Countess of Chester Hospital NHS Foundation Trust Lancashire Teaching Hospitals NHS Foundation Trust Liverpool Heart and Chest Hospital NHS Foundation Trust Liverpool University Hospitals NHS Foundation Trust Liverpool Women’s NHS Foundation Trust Mersey Care NHS Foundation Trust Mid Cheshire Hospitals NHS Foundation Trust NHS Cheshire and Merseyside ICB NHS Lancashire and South Cumbria ICB North West Ambulance Service NHS Trust St Helens and Knowsley Teaching Hospitals NHS Trust Tameside and Glossop Integrated Care NHS Foundation Trust The Christie NHS Foundation Trust The Clatterbridge Cancer Centre NHS Foundation Trust The Walton Centre NHS Foundation Trust Wirral Community Health and Care NHS Foundation Trust Wirral University Teaching Hospital NHS Foundation Trust Wrightington Wigan and Leigh NHS Foundation Trust Northern Country Durham and Darlington NHS Foundation Trust Gateshead NHS Foundation Trust North of England Commissioning Support (NECS) North East Ambulance Service NHS Trust Northumbria Healthcare NHS Foundation Trust South Tees Hospitals NHS Foundation Trust The Newcastle Upon Tyne Hospitals NHS Foundation Trust University Hospitals of Morecambe Bay NHS Foundation Trust South East East Sussex Healthcare NHS Trust Kent Community Health NHS Foundation Trust NHS Kent and Medway ICB NHS Surrey Heartlands ICB Queen Victoria Hospital NHS Foundation Trust South East Coast Ambulance Service Sussex Community NHS Foundation Trust Sussex Partnership NHS Foundation Trust University Hospitals Sussex NHS Foundation Trust Oxford Health NHS Foundation Trust Oxford University Hospitals NHS Foundation Trust Portsmouth Hospitals NHS Trust Royal Berkshire NHS Foundation Trust Solent NHS Trust South Central Ambulance Services NHS Foundation Trust Southern Health NHS Foundation Trust University Hospital Southampton NHS Foundation Trust South West Avon and Wiltshire Mental Health Partnership NHS Trust Cornwall Partnership NHS Foundation Trust Devon Partnership NHS Trust Dorset County Hospital NHS Foundation Trust Dorset Healthcare University NHS Foundation 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 NHS Devon ICB (One Devon) NHS Dorset ICB (One Dorset) NHS Gloucestershire ICB (One Gloucestershire) North Bristol NHS Trust Royal Cornwall Hospitals NHS Trust Royal Devon University Healthcare NHS Foundation Trust Royal United Hospitals Bath NHS Foundation Trust Salisbury NHS Foundation Trust Somerset NHS Foundation Trust South Western Ambulance Service NHS Foundation Trust Torbay and South Devon NHS Foundation Trust University Hospitals Bristol and Weston NHS Foundation Trust University Hospitals Dorset NHS Foundation Trust University Hospitals Plymouth NHS Trust West Midlands Birmingham Women’s and Children’s NHS Foundation Trust Dudley Integrated Health and Care NHS Trust Herefordshire and Worcestershire Health and Care NHS Trust Midlands and Lancashire CSU Midlands Partnership NHS Foundation Trust NHS Birmingham and Solihull ICB (BSol ICB) NHS Black Country ICB Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust Shropshire Community Health NHS Trust The Royal Orthopaedic Hospital NHS Foundation Trust University Hospitals Birmingham NHS Foundation Trust Worcestershire Acute Hospitals NHS Trust Yorkshire and the Humber Barnsley Hospital NHS Foundation Trust Bradford Teaching Hospitals NHS Foundation Trust Harrogate and District NHS Foundation Trust Leeds Community Healthcare NHS Trust NHS North West Yorkshire ICB Sheffield Children’s NHS Foundation Trust Sheffield Health and Social Care NHS Foundation Trust Sheffield Teaching Hospitals NHS Foundation Trust The Leeds Teaching Hospitals NHS Trust York and Scarborough Teaching Hospitals NHS Foundation Trust National employers Health Education England NHS Blood and Transplant NHS England NHS Resolution

Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To Know