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
Nurses are staging the biggest strike in NHS history with calls for a 19% pay rise.
The Royal College of Nursing says below inflation increases are compromising care by making it hard to attract and retain nurses.
The latest edition of Make Sense of Your World takes an in-depth look at why the UK is seeing nurses and so many other workers on picket lines.
Una Wilson is a research nurse and is on the picket line at Belfast City Hospital.
She says recruitment and retention of healthcare staff is a major issue.
"Every year we are operating with less and less staff and it means we cannot provide sufficient care for our patients."
Asked about the atmosphere at the strike she said: "The mood's been really good, not just from people on the picket line but the public as well are really showing their support.
"At the end of the day the NHS is our national treasure, the public support it, the pople who work in it love it, it just is chronically understaffed and staff are burnt out and underpaid.
"We have real passion for the jobs that we do and we want to provide good, safe care."
The Health Secretary Steve Barclay said the Royal College of Nursing's call for a 19% pay rise is "not affordable".
He said the government is "hugely grateful" for the work that nurses do and that's why the government accepted the independent pay review body's recommendations in full and awarded nurses with an extra 3% pay rise last year when the rest of the public sector had a pay freeze.
Anna Crossley
Reporting from Liverpool
"This has been the hardest decision I’ve ever made in my career and it was the hardest decision for all of the nurses out there today," says Liverpool nurse Daniella McLaughlan.
"This morning I had a nervous belly, I couldn’t have breakfast and I was still questioning whether this was the right thing to do because I didn’t come into nursing to strike."
She says the job is "stressful, it’s emotional and it’s hard work", adding that she believes patient care is being put at risk.
Staffing levels are poor because nurses cannot afford to stay in the profession, Daniella explains.
"They’re not able to pay the bills, so they’re leaving to get jobs where they can afford to live properly.
"I love my job so much and I will never leave nursing, but some people have to leave because it’s affecting their mental health, it affects their physical health and it affects their family life. So there might come a time when I have to leave because I have no other option.
"We know a lot of people are behind us, we’ve got people beeping their horns driving past… we’ve been given hot drinks and food.
"The public will keep going because we keep going for our patients - we do it everyday and night - and the public know that."
Image source, PA MediaMore now from Health Secretary Steve Barclay, who has been speaking to reports outside a hospital in London.
He's asked if it is right that nurses are going to food banks and claiming Universal Credit.
He doesn't answer the question directly, stating that the government has "an independent process" that looks at high taxes, cost-of-living pressures "and balances those with the needs of our NHS as well".
He says that the government accepted the recommendations of an independent pay review.
"But we also recognise the huge contribution that we saw from nurses during the pandemic and that's why last year we made a special case where nurses got an extra 3% when others in the public sector did not," he says.
Earlier Jerry Cope, former chair of the NHS Pay Review Body, said ministers should ask the body to reconsider their recommendations due to the huge rise in inflation.
Image source, POOLHealth Secretary Steve Barclay has spoken as thousands of nurses in England, Wales and Northern Ireland join picket lines.
He says that the government is "hugely grateful" to nurses but says the pay rise being demanded is unaffordable.
"In the autumn statement we committed an extra £6.6 billion of extra funding to the NHS," Barclay tells reporters at Chelsea and Westminster Hospital.
But the Royal College of Nursing (RCN) wants a 19% pay rise and says below inflation increases are compromising care by making it hard to attract and retain nurses.
Asked about the 19% pay rise, Barclay says: "We've got to balance that against what is affordable to the wider economy."
"Asking for 19% pay rise, way above what most viewers themselves are receiving, is not affordable given the many other economic pressures that we face," he says.
Nurses in England fall into different pay bands.
This chart shows the minimum and maximum salaries in 2022-23.
Those in the starting pay band, earn anywhere from £27,055 to £32,934.
Experienced nurses are paid £33,706 to £40,588 and specialist nurses earn from £41,659 to £47,672.
A consultant nurse can expect to be paid £48,526 to £54,619.
Image source, .
Image source, PA MediaJust joining us or need a re-cap? Here's the latest on the strikes:
Whether you're a nurse striking or a nurse who disagrees with the strike, we would like to hear from you.
If you're a patient whose treatment is affected by today's industrial action, you can get in touch in the following ways:
In some cases a selection of your comments and questions will be published, displaying your name and location as you provide it unless you state otherwise. Your contact details will never be published.
Health minister Helen Whately spoke earlier on BBC Radio 4's Woman's Hour.
In a lively interview, she was challenged by host Emma Barnett to explain how years of Conservative government had led to the biggest strike in NHS history.
Whately insisted that the government had been continuously investing in the NHS and that the door of Health Secretary Steve Barclay was "always open" to union representatives.
Earlier, the head of the Royal College of Nursing Pat Cullen had described that claim as "disingenuous" saying Barclay would only discuss non-pay issues.
Whately also said she was "disappointed" that nurses had gone on strike.
You can listen back on BBC Sounds
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Robert Cuffe
Head of statistics
When discussing the nurses strike, government minister Maria Caulfield told both BBC Breakfast and Radio 4's Today programmes that a 1% pay rise would cost £700 million pounds.
She told Nick Robinson on Today “for every per cent we would have to put pay up, that's £700 million we would have to find".
This is not correct when applied to the nurses’ pay dispute.
It would be correct if the average nurse or midwife earned nearly £200,000. But the average salary for a nurse is closer to £37,000.
The Department of Health and Social Care have told us that this figure actually covers the entire “non-medical” workforce in hospitals and community health services.
That does includes nurses (“medical” staff are defined as doctors).
But it also covers a much larger group of workers including (for example) scientists, porters, administrative staff, physiotherapists, radiographers, ambulance staff and management.
Sharon Barbour
BBC Look North
The picket line outside the Royal Victoria Infirmary in Newcastle has grown from a handful at dawn to more than 100 people now.
There’s music, a constant supply of food and hot drinks from passers-by and, it seems, non-stop tooting from supportive motorists.
But there’s also stress, anger and sadness on the faces of those holding placards and standing in the freezing cold.
Many told us they would much rather be with their patients inside, but that they needed proper recognition for their work. They were exhausted from the pandemic and from always being short staffed, they were stressed, angry and sad that it had come to this.
Philippa Roxby
Health reporter, BBC News
Despite thousands of nurses striking today, the 111 service is running as normal and people are encouraged to call if they need to.
There were 700,000 calls made to NHS 111 last week – the phoneline for anyone with non-emergency health issues – 60% more than the previous week.
It’s the highest number of 111 calls ever recorded, apart from two weeks right at the start of the Covid pandemic, according to NHS England.
Calls about strep A infection are fuelling most of that rise, with worried parents looking for advice on their children’s symptoms.
The bacterial infection has led to a surge in cases of scarlet fever and a very rare but severe condition called iGAS (invasive Group A strep) across the UK.
NHS bosses say the increase in calls is “understandable” and it’s more important than ever that the public uses 111 online where possible to get key information on where to go for the best possible care.
Kelly Hopkins has been a nurse for 25 years and has taken to the picket line in Liverpool.
She said understaffing was a major issue and she also felt "sad" when she went into work because her colleagues were struggling.
"I have connections with the food bank and there are more and more nurses using the food bank which is just not acceptable.
"They're coming into work to care for other people and no one's caring for them.
"They're having to use food banks, they're coming in cold, they're going without food to feed their children, it's just crazy."
Image source, EPAThe Deputy Chief Nursing Officer for England Charlotte McArdle has said all parties, including the RCN, would be "working carefully" today to "keep a very close eye", to "make sure care is delivered safely through all the 12 hours of the strike".
As the strikes lead for NHS England, McArdle said she would be "overseeing what is happening nationally" and "getting a sense of changes we need to make ahead of next Tuesday" when the next day of walkouts is scheduled.
She said: "Nurses need to feel valued and respected and should be rewarded with good pay and conditions in the NHS."
Asked if she felt striking nurses were letting people down, McArdle said: "Nobody wants to be on strike and these aren't decisions individual nurses have made lightly.
"They're very personal decisions. I'm personally working today because my role is not part of the strike."
Riyah Collins
Newsbeat reporter
Image source, Ellie McNicolEllie says she knew nursing would be hard but feels working conditions need to improve
Unions have said even new recruits were struggling to see a future in the NHS, as nurses struggle with workloads and rising prices not matching wages.
Student nurse Ellie McNicol only started her course at the University of Bristol last year but says she has already seen enough to know things need to change.
"Lots of mistakes are happening that shouldn't be due to staffing pressures," the 22-year-old told Newsbeat.
"I've seen it first-hand. We get a lot of pressure put on us.”
Ellie was inspired to get into nursing after caring for her brother when he was in an accident a couple of years ago.
"If I didn't feel so strongly about wanting to help people I'd consider dropping out," she says.
"I knew it was going to be hard. It's common knowledge that nurses don't get half of what they deserve."
As a student, she does not get paid for her time working on wards but receives a bursary to help with her travel costs.
Lisa Summers
BBC Scotland Health Correspondent
The Scottish Government offered NHS staff a pay offer averaging 7.5%.
To do that, they made cuts in other areas of health spending; including primary care, mental health and Covid funds.
Two unions have accepted the offer, however GMB - which represents the majority of ambulance staff in Scotland - has rejected it.
The union suspended a planned 26-hour walk out last month while it considered the offer. It has not set any new dates for strike action yet, and says it wants to get back round the table with the Scottish Government before Christmas.
Meanwhile, the Royal College of Nursing is still consulting its members, so while strikes are suspended for now - they are not ruled out.
Annabel Rackham
BBC reporter
Image source, ReutersPat Cullen is a name that has become synonymous with the nurses strike in recent weeks and as general secretary of the Royal College of Nursing, she is expected to be vocal on the picket line today.
She was born in Northern Ireland in 1964, growing up in County Tyrone. After failing her exams at 16, she was unable to continue to sixth form and so, instead, went to college to become a trainee nurse.
Her first job was in mental health nursing, working in hospitals before moving into the community.
Cullen is also a registered psychotherapist and worked as a psychiatric nurse in Northern Ireland. She went on to become the deputy director of nursing, safety, quality and patient experience in the Northern Ireland Public Health Agency.
In May 2019 she became the director of the Royal College of Nursing Northern Ireland, balloting members on industrial action over pay and low staffing levels.
Strike action then took place in December 2019 and January 2020, with Cullen seen as key in mobilising staff to strike and also acted as a media spokesperson.
She was integrated into the national set up in 2021 and used her experience in Northern Ireland to mobilise nurses across the rest of the UK to vote on strike action.
Nurses are striking at 76 NHS services across England, Wales and Northern Ireland.
Staff will continue to provide "life-preserving" and some urgent care but routine surgery and other planned treatment is likely to be disrupted.
You can see if an organisation is affected in your area using our interactive table here.
The GMB union has voted to reject an improved NHS pay deal from the Scottish government.
The union represents NHS ambulance staff, nurses, porters and radiographers
It said 66% of their members voted to reject the improved offer, which would have seen workers receive average 7.5% pay uplift.
The GMB suspended a planned 26-hour ambulance strike last month and put the new offer to members in a vote.
Members of Unite and Unison voted to accept the offer earlier this week.
Ballots of the Chartered Society of Physiotherapy (CSP) and Royal College of Nursing (RCN) members are ongoing.