We'll be pausing our coverage shortly. Here's the latest on the nurses' strikes:

• The Royal College of Nursing has announced that nurses across England, Wales and Northern Ireland will go on strike on 15 and 20 December in a pay dispute with the government
• NHS leaders said they would do "everything in their power" to minimise disruption
• Pat Cullen, the general secretary of the RCN, said nurses were "pushed to the position" of strike action
• Nurses will continue to provide "life-preserving" care during the strikes, Cullen said
• Health Secretary Steve Barclay said he "deeply regrets" the RCN's decision to stage strike action, but said it was important to respect the recommendations of the independent NHS Pay Review Body
• Shadow Health Secretary Wes Streeting criticised Barclay for "refusing to negotiate with nurses"

Read more here

Today's coverage was written by James Harness, Sam Hancock, Aoife Walsh, Andre Rhoden-Paul, Gemma O'Reilly and Anna Boyd, and edited by Nathan Williams.

A midwife in central London says she and her colleagues are working 13-hour shifts with no breaks.

Lauren Nielsen said the situation was down to low staff numbers and demanding levels of paperwork.

She said: "I just want to be able to eat my dinner."

Ms Nielsen isn't due to go on strike but supports the walkouts.

She believes it's much easier for bus and train drivers to take industrial action than it is for nurses adding: "We turn up because patients will die if we don't."

Nurse Lauren Cavile, 32, said after receiving her monthly wage she was struggling to pay bills. She thought she did not earn enough to be "overworked", "fatigued" and "burnt out".

Fellow nurse Kate Sturmer, 27 and who has worked in Australian hospitals, described the pay in the UK as "(seemingly) the lowest".

Image source, Getty Images

Under trade union laws life-preserving care has to be provided.

Therefore, all nursing staff would be expected to work in services such as intensive and emergency care.

Other services, such as cancer treatment or urgent testing, may be partially staffed.

Details will be negotiated by local service managers and union representatives.

It is also possible that nurses could be pulled off picket lines to work if there are safety concerns during a strike.

This happened during the 2019 walkout in Northern Ireland by RCN members - the only other time the union has been involved in strike action.

Routine services - including planned operations such as knee and hip replacements, community nursing services and health visiting - are expected to be badly affected.

Read more here

Simply put, pay. The Royal College of Nursing is asking for 5% above the RPI inflation rate, which is currently above 14%. That would mean more than a 19% rise, which the government says is unaffordable. Currently no UK nation has offered a pay rise like this.

NHS staff were awarded a 3% rise in 2021 to recognise their work in the pandemic. Since then they've had an average increase of 4.75%. This means that the lowest paid were given a rise of at least £1,400.

The RCN says that this year's pay rise, along with years of squeezes on nurses salaries isn't enough. It pointed out that once inflation is taken into account, average pay for nurses fell by 6% between 2011 and 2021.

As a result the RCN says that this is disrupting care, because of the difficulty in attracting and retaining nurses.

The government in England has said that this year's pay rise is in line with what the independent NHS Pay Review Body recommended.

Read more here

Image source, Getty

Health Secretary Steve Barclay says he "deeply regrets" the Royal College of Nursing's (RCN) decision to stage strikes next month.

He says the government is working with NHS leaders on contingency plans for strike days, but accepts there will be "an impact on patients".

Barclay says the RCN's pay demands are not affordable.

"The asking terms of 17.6% on pay - around three times what many viewers are themselves getting in the private sector - is not, within the economic conditions we face, affordable at this time," he says.

The health secretary says he is "very keen" to engage with the RCN, but adds that it's "important to respect" the independent NHS Pay Review Body's findings.

"I have agreed to implement those in full, and I think that is the right way forward."

He says his "door remains open" to trade unions to discuss how to better support nurses and improve working conditions.

Sam Hancock
Live reporter

Image source, Getty Images

These strikes may be the biggest by nurses in NHS history, but staff members belonging to the health service have been staging walkouts since the 1970s.

Let's take a look at some of them.

1975: Between January and April, consultants protested against proposed new contracts which they said would force them to abandon private practice. In November, it was the turn of junior doctors who took action over pay and conditions set out in new junior staff contracts.

2014: Almost 40 years later, thousands of nurses, midwives and ambulance staff went on strike in England and Northern Ireland. It came after ministers awarded only some NHS staff a 1% pay increase, which an independent review board said should've gone to everyone. Then Health Secretary Jeremy Hunt claimed hospitals would be forced to lay off staff if the award was met in full.

2015: The following year, midwives in Northern Ireland staged a further four-hour strike, saying that 1% pay rise still hadn't been given to all staff in the region - only some.

2016: One of the most memorable NHS strikes in recent history is the action junior doctors took six years ago. There's an explainer on it here but essentially there was a disagreement over new contracts in England. The strikes marked the first time doctors stopped providing emergency care in the history of the NHS.

2022: And that brings us to next month's strikes, which will see more NHS nurses strike in the UK than ever before.

Image source, Carmel O'Boyle

Carmel O'Boyle has worked within the NHS for 26 years.

Speaking to BBC Radio 5 Live, Carmel says: "It's not something that we wanted to do, this decision to strike was agonised over but we feel there is nothing else to do to get the government to listen to us."

"Nobody wants to go on strike," she says, "we want to be able to care for our patients properly, but we can't do that without enough nursing staff and we can’t do that without proper pay."

Carmel says: "Without properly funding the NHS workforce there won’t be an NHS and we're all NHS patients."

The UK is facing strike action across several industries this winter.

Rail

Rail union RMT is looking for a pay rise of 7% and reassurance jobs will not be cut.

A series of walkouts have caused travel disruption across the country.

Now negotiations have reached deadlock, and earlier this week the RMT announced a series of new walkouts in December and January.

Train drivers union Aslef say their drivers' pay is not going as far due to inflation.They have organised a further strike for tomorrow affecting 12 train companies.

Post

The Communication Workers Union (CWU), which represents 115,000 workers at Royal Mail, are in a long-running dispute with company around jobs, conditions and a wage rise "that fully addresses the current cost of living".

Last month they rejected a 7% pay offer over two years. Workers are now striking over a series of dates this month and in December.

Royal Mail said it has made its "best and final offer" with a 9% pay rise over 18 months and it would make no compulsory redundancies before March next year.

Education

Thousands of teachers went on strike in Scotland yesterday over pay, leading to the closure of nearly every primary and secondary school in the nation.

SNP Education Secretary Shirley-Anne Somerville said their demands for a 10% pay rise were "unaffordable".

Scotland's largest teachers' union Educational Institute of Scotland has not ruled out further strikes.

Meanwhile, 70,000 staff at 150 universities across the UK are set to strike today and next week over "attacks on pay, working conditions and pensions".

Image source, Getty Images

Amid all the reaction to these strikes, let's take a step back and briefly look at the state of the NHS.

As we reported earlier, Rachel Power, of the Patients Association group, highlighted three of the main issues currently affecting the UK's health service:

• backlogs from the Covid-19 pandemic
• ambulance and A&E delays
• staff shortages

Last month, the Care Quality Commission (CQC)'s annual report warned that England's health and care system is gridlocked with patients because they can't access the support they need.

The report specifically blamed staffing shortages for the majority of issues, with one-in-10 posts in both the NHS and social-care sector found to be vacant. (In the context of the nurses' strikes, they say bad pay will lead to less people applying to take on nursing roles.)

More statistics have come to light since then. The BBC's health correspondent Nick Triggle reported yesterday that around three in 10 ambulances are being caught in queues outside hospitals in England - leading to patients dying and being harmed on a daily basis.

And with temperatures dropping, NHS England data shows that ambulance wait times are at their worst for the beginning of winter since records began.

Image source, Getty Images

More than 40,000 nurses have quit the NHS in England, recent figures show.

The record numbers equate to one in nine of the workforce, according to analysis by the Nuffield Trust think tank for the BBC in September.

It said many of those who left were highly skilled nurses with years more of work to give and the high number of leavers were cancelling out the rise in new joiners.

The analysis showed there were just 4,000 more joiners than leavers in the year to the end of June.

A Department of Health and Social Care spokesman at the time said progress was being made and the government was already halfway to meeting its target to increase the numbers of nurses working in the NHS in England during this Parliament by 50,000.

You can read more here.

Hugh Pym
BBC News Health Editor

We now know the planned strike dates by nurses in England, Wales and Northern Ireland. But there's a lot we don't know.

Which hospitals and health organisations will see walk outs?

Some trusts and boards did not meet the required legal threshold in their ballots so nurses will not strike there. But beyond indications from the Royal College of Nursing that "most" of the rest will be affected by the action we don’t have any details yet.

Crucially the distinction between non-urgent care, (which will be suspended during strikes) and emergency care (which will be preserved) has not been clarified.

This will be negotiated locally in talks between the union and employers but patients, including some needing cancer treatment, will want to be reassured about the impact on their care.

That being said, strikes by junior doctors in England in 2016 went ahead with clear agreements on sustaining emergency services.

What is clearer is that right now Scotland and the rest of the UK are on divergent paths. A higher offer from the Scottish government has led health unions to suspend planned action and at least one to recommend it to their members.

The line from ministers in England and Wales is that no improvement to the existing award is possible.

NHS Trust leaders say they'll do "everything in their power to minimise disruption for patients" when nurses plan to strike in December.

Saffron Cordery, the interim chief executive of NHS Providers, said her organisation understands nurses' concerns and urged the government to "act fast" to try to prevent industrial action.

She said: "Trust leaders' priorities are ensuring the safe delivery of care and supporting the wellbeing of staff who continue to work flat out in the face of below-inflation pay awards, severe staff shortages and ever-increasing workloads."

A nurse has told BBC Question Time how voting to strike was a "really difficult decision".

Speaking to the panel, she says: "Fund us properly, make nursing and health and social care generally a good profession that's well paid with good working conditions.

"We want to be proud of our profession.

"I've just voted to strike and that was hard, that was a really difficult decision."

In response, government minister Richard Holden said more funding "than ever before" was being given to the NHS.

Image source, Getty Images

In December we won't see a total walkout of nurses on each strike day. This is because the Royal College of Nursing (RCN) may decide to stagger the walkouts, and not every nurse is eligible to strike.

Strike ballots were held at individual NHS trusts and boards rather than one national ballot - at more than 40% of England's hospitals, mental health and community services the voter turnout was too low, meaning nurses there are not entitled to strike.

GP services will also be unaffected as nurses working in practices were not entitled to take part in the ballot.

Walkouts can happen at all of Northern Ireland's health boards and in all-but-one in Wales, the Aneurin Bevan.

What is not yet clear is just how many of the services where strike action can take place will see walkouts. It is possible the RCN could stagger the action so some services go on strike in December, with others to follow suit next year if the industrial action continues. It is seen by the union as a way of limiting the disruption to patients, while keeping the pressure on the government.

Individual NHS trusts and boards will find out next week whether they will see walkouts on the two December dates, because that is when the formal notices go out.

BBC's 5Live programme has been hearing reaction to the nurses' strike action set to go ahead next month.

Here's what one nurse who doesn't want to go on strike had to say:

About 42% of NHS nurses in England are in a "Band 5" pay bracket. That's the pay grade for newly qualified nurses - their salaries range , externalbetween £27,055 and £32,934.

Band 6 is more senior nurses and specialists and their basic pay is between £33,706 and £40,588.

Band 7 includes ward sisters and junior matrons, earning between £41,659 and £47,672.

Band 8 is divided into four sections, including senior matrons, heads of department and nurse consultants, who can earn between £48,526 and £91,787.

There are also 306 nurses in Band 9, who are chief nurses or deputy chief nurses and can earn between £95,135 and £109,475.

Read more: What is average pay for nurses?

Image source, .

Image source, PA Media

We've heard this morning from Pat Cullen, the Royal College of Nursing's (RCN) general secretary and chief executive, who will lead nurses across England, Wales and Northern Ireland into industrial action in December.

But who is Pat Cullen?

Cullen was born in Northern Ireland, and trained as a nurse train during the Troubles.

In 2016, she joined the RCN's Northern Ireland branch. She led the union's first-ever strike three years later, seeking pay parity for Northern Irish nurses with those working elsewhere in the United Kingdom.

Since 2021, Cullen has been the interim leader of the RCN at national level.

LISTEN: Learn more about Pat Cullen on BBC Sounds.

Image source, Getty Images

Let's get a sense of what the Labour Party's saying about these strikes.

Shadow health secretary Wes Streeting has been on Twitter this morning, asking "why on earth" Steve Barclay, the UK's health Secretary, is "refusing to negotiate with nurses".

"Patients already can’t get treated on time, strike action is the last thing they need. Strike action is the last thing that nurses want. If strikes happen, patients will know who to blame," he writes, alongside an image of Barclay and PM Rishi Sunak.

Though he avoids saying whether his party would pay the 19% pay rise - inflation rate plus 5% - nurses are seeking.

Labour's chairwoman Anneliese Dodds did something similar a few hours before. Pressed by Sky News on whether Labour would back the rise, she said: "Well, it's not reasonable for a politician to sit and pontificate about, you know, 1% up, 1% down, I'm not going to do that."

She added it was "wrong" that nurses felt they had no other option but to strike - and warned of the "hugely disruptive" impact it would have on patients.

We're hearing more now from nurses who will be taking part in strike action.

The strike isn't about "having a few quid extra in a pay packet", Helen, a nurse, tells the BBC.

"This is a much wider picture," she says. "We are completely depleted."

Helen says the strikes are about "pay and recognition".

Nurses in England, Wales and Northern Ireland have voted to strike next month over pay.

The action will largely interfere with elected treatment. Unions insist that emergency treatment will remain in place. But either way, strike action will "inevitably" have an "impact on services", according to Health Secretary Steve Barclay.

So, how much do you know about nurses' pay? The BBC's Laura Foster tests your knowledge.