Thousands of nurses in England, Wales and Northern Ireland are on the first of two day-long strikes over pay - a walkout will also take place on 20 December
The Royal College of Nursing wants a 19% pay rise and says below inflation increases are compromising care by making it hard to attract and retain nurses
But Health Secretary Steve Barclay says that figure is "not affordable given the many other economic pressures that we face"
Speaking on a picket line earlier, RCN chief Pat Cullen said "this is a tragic day for nursing, it’s a tragic day for patients"
Staff will provide 'life preserving' and some urgent care, but routine services are likely to be disrupted
While critical services like chemotherapy and kidney dialysis should run as normal, the biggest impact is likely to be on pre-booked treatment
We're going to end our live coverage of the NHS strikes now, so many thanks for following through the day.
As we've been reporting, nurses in England, Wales and Northern Ireland are next due to stage walkouts next Tuesday, 20 December.
This page was written by George Wright, Jo Couzens, Anna Boyd and Sam Hancock. It was edited by Jeremy Gahagan and Rob Corp.
Image source, ReutersThe comments have been coming thick and fast today from ministers, union representatives and nurses on strike. Here's a recap of some of what's been said:
Image source, PA MediaWe’ll be ending our live coverage of the RCN strike shortly, but here’s a reminder of what's happened today:
Reality Check
We've heard from a number of government figures today, including Health Minister Maria Caulfield, who earlier said it would cost the government £700m to increase nurses' pay by 1%.
She made the claim on BBC Breakfast and Radio 4's Today programme in relation to nurses in England, but there's been some confusion about its validity.
In short, this figure - which comes from an NHS Pay Review report, published in July, external - is not correct when applied solely to the nurses' pay dispute.
The report details how each additional 1% of pay for the "non-medical workforce" costs around £700m per year. While the "non-medical workforce" in the NHS includes nurses, it also covers a much larger group of workers including scientists, porters, physiotherapists, radiographers and ambulance staff.
This means the 1% Caulfield speaks of doesn't apply to just nurses - in fact it covers more than twice as many staff in the NHS in England. Read more about this here.
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Image source, .Nurses are striking at 76 NHS services across England, Wales and Northern Ireland.
Staff are continuing to provide "life-preserving" and some urgent care but people have been warned that routine surgery and other planned treatment could be disrupted.
If you want to know whether an organisation is affected in your area, use our interactive table, which can be found here.
We’ve been contacted by Eamon, a theatre nurse who works for the University Hospitals Birmingham NHS and has been in the profession for nearly 20 years.
“I’m striking more in solidarity with my colleagues than thinking about myself really. The conditions on many wards are appalling and many nurses are at breaking point.
“The conditions are getting worse year on year. Every year we’re sent to the wards because of winter pressures. That didn’t really happen pre-2012. Day case wards are being used as additional space for medical patients and elective surgery is just stopped every year.
“Staff retention is getting worse. Staff are walking away. The pandemic has also put stress on people. Many of my colleagues have PTSD now.
“We have 46,000 nursing vacancies, external in the NHS in England alone and that has a knock-on-effect on the wards.
“The NHS needs to cover these staff vacancies and they are covering them with agency staff and it's a false economy. The NHS is spending a fortune on agency staff when they could pay nurses more and let them know that they are looked after.
“When it comes to this strike, patient safety is at the top of the list because if you don't have enough staff for the wards, it's not safe.
Prime Minister Rishi Sunak has previously said that the Royal College of Nurses’ pay demands are “not affordable” but Eamon believes the government would gain money in tax and increased staff retention would also mean the NHS saves money on agency staff.
“It costs thousands of pounds to train a nurse and we’re losing so many after two years of them qualifying and it's such a waste of their training and investment.”
As we've touched on already today, it's not just nurses in England taking to the picket line. In fact, there's action across the UK.
In Wales, thousands of appointments and procedures were set to be affected after workers staged their first strike as a dispute over pay deepens.
Nurse practitioner Sue Williams, who was on the picket line at Ysbyty Gwynedd in Bangor on Thursday morning, said it was a "very emotional" and "really sad day".
It's a similar situation in Northern Ireland, where nurses joined colleagues in England and Wales in a 12-hour strike. In all three countries, life-saving care has continued to be provided but planned surgery was disrupted.
Meanwhile in Scotland, there are no strikes but some related news. The GMB union - which represents NHS ambulance staff, nurses, porters and radiographers - today voted to reject the latest pay deal from the Scottish government. Others voted to accept the offer earlier this week.
Image source, PA MediaKatharine Da Costa
BBC News
Around 50 nurses from the Oxford Hospitals NHS Foundation Trust have huddled together outside in temperatures of -2C at the front of the city’s main John Radcliffe hospital.
There are plenty of honks and cheers from passing motorists giving those on strike a boost of encouragement. The common theme from staff is feeling undervalued and underpaid.
Oxford is one of the most expensive places to live outside of London and in this cost of living crisis many are struggling.
Amongst them are husband and wife Anil and Kavya with their one-year-old daughter. Both parents are nurses from India and have worked at the trust for eight years but say life is difficult: “We can’t afford housing, we can’t afford childcare,” Kavya says.
The pair hope the government is listening and provides more support.
Image source, PA MediaA new Ipsos poll finds four out of five (80%) Britons are worried about the NHS's ability to provide safe care for patients during the strikes.
While around half of the 1,000 adults surveyed say they support the industrial action, the majority express concern about the impact on patient safety. Some 34% say they oppose the action.
Ministers say around 70,000 appointments, procedures and surgeries will be lost in England as a result of the strike, and thousands more are likely to be affected in Northern Ireland and Wales.
Meanwhile, 82% of those questioned in the poll say they are very or fairly concerned about patient safety during the ambulance workers' industrial action, with the first strike planned for 21 December.
But 47% of those questioned say they are supportive of the ambulance worker strikes. Some 37% say they are against it.
The latest poll shows that the proportion of people who believe it is acceptable for healthcare workers to strike for better standards of patient care is 68%, while 61% say it is acceptable in seeking a pay rise.
This is down from the 74% of Britons who said in November it was acceptable for nurses to strike over patient care standards and 71% who said it was acceptable for them to take industrial action for a pay rise.
Members of the Royal College of Nursing explain to BBC News their reasons for walking out from their jobs for 12 hours in a dispute over pay.
'Nurses are using food banks now'
The photos coming out of today's historic action by the RCN range from the expected - groups of strikers chanting - to the sight of nurses holding signs saying they're "broke and broken".
There has also been some support from a five-year-old greyhound in Bristol.
Here's a snapshot of some of the picket lines from all over the country.
Image source, PA MediaLiverpool
Image source, ReutersLondon
Image source, ReutersLondon
Image source, PA MediaBristol
Image source, PA MediaLondon
Labour could not afford the Royal College of Nursing's (RCN) headline pay demand of inflation plus 5% if it was in government today says the shadow health secretary.
Speaking on Wednesday, before thousands of nurses in England, Wales and Northern Ireland went on the first of two day-long strikes over pay, Wes Streeting told the BBC's Hardtalk programme Labour would at least be willing to talk about pay.
Image source, PA MediaJust joining us or need a re-cap? Here's a reminder of the latest on the strike today:
A nurse working for an NHS trust in London, whose members are not on strike, has joined a picket line at a different capital hospital in a show of solidarity.
Chelsea Barrett, who is 22, joined NHS staff outside St Thomas' Hospital and told the PA news agency she wanted to show support.
She said: "When I'm talking to my friends we always say we started nursing thinking it was going to be something else completely. We would keep our patients safe.
"Now that we've started the system has just broken us, we've tried so hard to take care of our patients and we're being left with too many patients, to a point where we don't feel like they're safe any more.
"All the media are saying we want extra money, obviously we do in a sense, but it's not even that, it's about people's families, they are not safe."
Image source, PA MediaFirefighters belonging to the Fire Brigades Union join nurses on a picket line outside St Thomas' Hospital in central London
Laura Foster
BBC Health correspondent
When it comes to deciding how much of a pay rise NHS staff should be given, governments in England, Wales and Northern Ireland turn to an independent group for a recommendation.
That group is the NHS Pay Review Body. It looks at information from governments, unions, the NHS and employers.
Its recommendations are currently being followed, but they don’t have to be. They’re just guidelines.
A month ago, they were asked to start looking at what should happen when it comes to nurses’ pay during the next financial year.
Today the NHSPRB confirmed they are preparing to deliver a recommendation for pay that would start from April 2023.
Nikki Fox
BBC Look East
Addenbrookes Hospital in Cambridge is a national centre for both cancer and children's care and although the chief nurse has told us emergency care is going ahead.
The hospital has had to cancel 2,000 appointments over the two days of strike action today and next Tuesday.
It has apologised to patients and says it will get appointments rearranged as soon as possible, adding that it wants to support staff.
One nurse told me some staff are having to use food banks. Another has had to spend a few nights in a car as she didn't have the money for her rent.
They're sorry for the impact on patients but say safety is being compromised on a day to day basis as too many nurses are leaving.
Staff are also striking at the nearby mental health trust. Almost a fifth of mental health nursing roles in the East of England are unfilled by permanent members of staff.
Anthony’s daughter will qualify as a nurse this year and she’s already feeling demoralised by the working conditions.
"She was always dressing up as a nurse when she was tiny and I’m very proud that she always wanted to be a nurse but there’s a big however now," Anthony tells BBC 5 Live.
“She’s experienced placements on wards and seen first-hand how demoralised nurses are.”
Anthony says his daughter was “really excited to going into training to be a nurse,” but now “she’s come home from placements crying”.
He says his daughter is seeing nurses "who feel they are completely undervalued, who can’t cope and who are suffering from stress because the demands placed upon them are completely unreasonable".
“If you can’t enthuse and get young people excited about a career in nursing we have a fundamental problem for the future," Anthony adds.
“I absolutely support the nurses going on strikes today, we have got to do something."
David Brown
BBC News Visual Journalism Team
Today’s strike is the first of two days of industrial action by nurses in England, Wales and Northern Ireland.
Then tomorrow there will be strikes by workers on the railways and highways, as well as driving examiners, and among staff at Abellio buses.
Next week, ambulance staff and Border Force employees are expected to stop work, with other industrial action continuing through Christmas and the new year.
UPDATE 15:10: We're just hearing that tomorrow's planned strike by some baggage handlers at Heathrow has been suspended following last-minute talks. We'll update the graphic below shortly.
Image source, .
Image source, PA MediaDame Ruth May joined nurses outside St Thomas' Hospital in London
Downing Street says England's chief nursing officer was not speaking for the government when she apparently backed striking nurses on the picket line.
Dame Ruth May joined nurses outside St Thomas' Hospital in London and later said she wants to see a resolution to the row over pay.
She said on the picket line she supports striking nurses - and ministers must reach an "urgent resolution" with the Royal College of Nursing (RCN), according to the Times.
Asked about her joining striking nurses, the prime minister's official spokesman said: "She doesn't work for the government. She's not a minister.
"Obviously she has her own view as chief nurse. The government must consider what is a responsible action in the round."
Health Secretary Steve Barclay said: "I spoke to Ruth May ahead of today and what she was very clear on is she wanted to support all nurses."
"And I think as chief nurse that's absolutely right that she is a hugely respected figurehead across the nursing profession."
Image source, PA MediaNHS staff in Scotland voted to go on strike in early November, but this was put on hold after the Scottish government agreed to fresh talks with health unions over pay.
The Royal College of Nursing (RCN) has asked for a rise of 5% above inflation - the rate prices are rising - which is currently above 14%.
The Scottish government initially offered NHS staff a flat rate of £2,205 per person, backdated to April, but the RCN rejected the deal - describing it as a real-terms pay cut.
Unite, the GMB union and the Chartered Society of Physiotherapy had also backed strike action.
But an improved pay offer averaging 7.5% has since been made to health workers and is currently being considered by unions.
Unite and GMB both suspended action by ambulance staff and said that the offer will be put to members in a ballot.
However, the GMB announced today that its members had rejected the improved offer.
The RCN said that its board members would consider the details of the offer that "still does not meet our members' expectations".
The Scottish government said the new deal was a "record high pay offer".