Hospital bosses "cannot guarantee patient safety" during tomorrow's ambulance strike and there is "deep worry", says the NHS Confederation
Tens of thousands of workers are set to strike in England and Wales over pay, with military personnel asked to support services
The latest talks between the government and unions ended with both sides voicing disappointment - and the health secretary calling union pay demands "unaffordable"
Five ambulance trusts have declared critical incidents ahead of the planned action, citing high demand and difficulty handing patients over to hospitals
Tomorrow's action comes a day after a second walkout by nurses in England, Wales and Northern Ireland
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
The prime minister has insisted he will not back down against striking workers, including nurses, urging them to consider whether strikes are "really necessary"
Nurses are striking at 76 NHS services across England, Wales and Northern Ireland. You can see if an organisation is affected in your area using our interactive table here.
Image source, ReutersScottish Health Secretary Humza Yousaf meets nurse Laura Hastings during a care home visit
Today's nursing strike involves staff in England, Northern Ireland and Wales - but not Scotland.
That's because unions in Scotland have called off strike action following an improved NHS pay offer from the Scottish government.
NHS Scotland staff have been offered an average pay rise of 7.5%. It is a bigger rise than nurses have been offered in England, Wales and Northern Ireland.
Two unions that represent nurses - Unite and Unison - have accepted the pay offer.
The Royal College of Nursing, whose members are taking part in strike action today in the rest of the UK, has been balloting its members in Scotland and is set to announce the results this week. It has called off strike action until the result is finalised.
Estephanie Dunn, regional director for the Royal College of Nursing (RCN) in the north-west of England, says union members "feel desperate" after facing years of pay squeezes.
Speaking to BBC Breakfast this morning, Dunn says that the nurses' requests for a 19% pay rise represent a solution to the fact "nurses are 20% behind in real terms".
She also says that 2023 could see "more of the same" in terms of strikes.
Asked what it would take to stop the strikes, Dunn says: "Firstly, it would be for the secretary of state for health to meet with the nurses' union and talk and negotiate - that has been on the table since before the first strike last week and we've still had no contact to invite us to talk about nurses' pay."
Health Secretary Steve Barclay has called the union's pay demands "unaffordable". Speaking ahead of the strike, he said he was "open to engaging with the unions".
Image source, BBC NewsAs thousands of nurses in England, Wales and Northern Ireland stage a second day of strike action, we want to hear from you.
Whether you're a nurse who is striking, a nurse who is against the strike or a patient whose treatment has been affected, please get in touch.
You can contact us 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.
WATCH: Armed Forces not allowed to "break the law by driving through red lights" - Will Quince
More from Health Minister Will Quince, who has warned people against taking part in "risky activity" on Wednesday ahead of ambulance strikes.
Speaking to BBC Breakfast, Quince says he is "hugely grateful" to members of the armed forces covering the strikes on Wednesday.
Some 750 military personnel will be supporting NHS trusts, he says, but they will not be able to break red lights or turn on blue lights when they're driving the ambulances.
The health minister says he is concerned about Wednesday's planned action, and urged members of the public: "Where people are planning any risky activity, I would strongly encourage them not to do so."
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 care during the strike.
In a letter to NHS bosses, external earlier this month, the RCN confirmed chemotherapy, dialysis, or intensive care services will not be hit by the strike action.
However, it said other services which do not meet this criteria may be reduced to a “Christmas Day” or “night duty” staffing level.
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.
Routine services - including planned operations such as knee and hip replacements, community nursing services and health visiting - are expected to be badly affected.
Health minister Will Quince says he is not willing to open negotiations about pay because the government has already accepted the recommendations of the independent pay review body in full.
Speaking to BBC Breakfast, he says the union's demand of a 19.2% rise is unaffordable as it adds up to £10bn.
On tomorrow's planned walk out by ambulance staff in England and Wales, Quince says he is "concerned" as there is going to be disruption. "But I've been absolutely clear... there is a minimum level of service that will be required," he says.
Nick Eardley
Chief political correspondent
There are two things I can see as potential olive branches here.
One is some sort of one-off payment to recognise the cost of living pressures.
Downing Street has been playing that down over the past 24 hours, saying it's certainly not on the table at the moment.
The other thing which the government keeps talking about is next year's pay deal and perhaps some movement on that - some tinkering of how that could be calculated.
But that's not good enough for the unions.
I've asked a lot of people in government over the last few days what the end game is for the government and I don't think there's a clear answer, apart from hoping that the unions end up accepting the current deal and then get back around the table to discuss a new deal for next year.
More now from RCN general secretary Pat Cullen.
Nurses will have "no option but to continue strikes into January" if there isn't a change in approach from the government, she has told BBC Radio 4's Today programme.
Cullen has also said at that stage "unfortunately more nursing staff will be involved" and "further hospitals will be included in the industrial action".
When asked if some areas currently protected, such as cancer appointments, could be included in future strikes, Cullen says "those decisions have not been made yet" but adds "safety will be the first consideration".
Image source, PA MediaPat Cullen joined the picket line outside Newcastle's Royal Victoria Infirmary early on Tuesday
Royal College of Nursing (RCN) General Secretary Pat Cullen has said "we are truly sorry" for every patient that has their care disrupted because of the nursing strikes.
However, she adds that any disruption to a health service "that's as fragile as ours" is something that this government "really needs to take a long, hard look at".
Speaking to BBC Radio 4's Today programme, she said Prime Minister Rishi Sunak should ask himself why nurses are about to strike for the second time in their history.
Cullen urges Sunak to meet with her to discuss solutions rather than talking to nurses "through the safety of the media".
Image source, EPASpeaking ahead of the strike, Health Secretary Steve Barclay says it is "disappointing" that some nurses are striking - and calls the Royal College of Nursing's pay-rise demands "unaffordable".
The RCN is calling for a pay rise for nurses of 5% above inflation, which would mean a pay rise of more than 19%.
Barclay says:
Quote MessageI hugely value the work of our NHS staff and it is disappointing some union members are going ahead with further strike action when we know the impact this has on patients.
Quote MessageThe RCN’s demands are unaffordable during these challenging times and would take money away from frontline services while they are still recovering from the impact of the pandemic. I’m open to engaging with the unions on how to make the NHS a better place to work.
Barclay adds that he's been working with the NHS and across government to "protect safe staffing levels".
"The NHS remains open, patients should continue to come forward for emergency and urgent medical care. They should also continue to turn up to appointments unless they have been contacted by the NHS."
The RCN says nurses' salaries have been squeezed for years, which it says compromises patient care because it makes it difficult to attract and retain nurses.
In total, more than 70 NHS organisations will see strike action from nurses today. They include:
Emergency care will continue to be provided during the walkouts. GP services will be unaffected as nurses working in practices were not entitled to take part in the ballot.
Strike action has been suspended in Scotland after ministers there made a fresh pay offer. It has been accepted by some unions, but others such as the RCN are still consulting members.
The strike ballot was sent to 300,000 RCN members - representing around two-thirds of the nurse workforce.
And because a series of individual ballots were held at NHS trusts and boards, rather than one national ballot, nurses at more than 40% of England's hospitals, mental health and community services are not entitled to strike because the turnout was too low in those votes.
The Royal College of Nursing (RCN) is calling for a rise of 5% above the RPI inflation rate, which measures how much prices are going up over time and is currently higher than 14%.
That would mean more than a 19% pay rise, which the government has said is unaffordable.
NHS staff in England and Wales - including nurses - have been given an average increase of 4.75%. The lowest-paid nurses were guaranteed a rise of at least £1,400.
In Northern Ireland, nurses have now been told they will receive the same pay award and the increase will be back-dated, external.
In Scotland, NHS staff were initially offered 5%, which was later changed to a flat rate of just over £2,200 - and was rejected by the RCN. An improved pay offer averaging 7.5% has since been made and has been accepted by some unions. Others, including the RCN, are still considering it. Nurses are not striking in Scotland.
The RCN says this year's below-inflation pay award followed years of squeezes on nurses' salaries. It says average pay for nurses fell by 6% between 2011 and 2021 - once inflation is taken into account - compared with a 4.6% drop across the whole UK workforce.
The RCN says this is compromising care, because it means the NHS is struggling to attract and retain nurses.
But Health Secretary Steve Barclay has called the strikes “disappointing” and strikers’ demands “unaffordable”.
The government has also said this year's pay rise is in line with what the independent NHS Pay Review Body recommended.
Read more here.
Good morning and welcome to our live coverage as nurses across England, Wales and Northern Ireland go on strike for the second time this month.
The walkout follows a dispute with the government over pay and will involve members of the Royal College of Nursing (RCN) in about a quarter of hospitals and community teams in England, all health boards in Northern Ireland and all but one health board in Wales.
Last Thursday, the first strike day, at least 19,000 patients had surgeries and appointments postponed - according to figures released by NHS trusts in England and Northern Ireland. In England alone, 9,999 staff were absent from work because of the strike.
Nurses will still provide life-preserving care, but other services, such as some cancer treatment or urgent testing, may be partially staffed. Routine services, such as planned operations, district nursing and mental health care will be affected.
Stay with us as we bring you the latest developments throughout the day.
Image source, Getty Images