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Four risks to NHS if Government fails to re-open pay talks

Four risks to NHS if Government fails to re-open pay talks
By Jess Hacker
6 February 2023



Work underway to reform the NHS and recover elective services will risk being further delayed further if the Government does not reach an agreement over strikes.

It comes as both nurses and ambulance staff take to the picket line today (6 February), marking the single biggest day of strike action in the NHS.

The Royal College of Nursing has said Prime Minister Rishi Sunak is refusing to open formal pay negotiations, which would stop nurses striking.

Pat Cullen, chief executive, said that Mr Sunak’s Government looks ‘increasingly isolated’ in refusing to reopen discussions about the 2022-23 NHS pay award.

Health leaders are again urging the Government to ‘show initiative’ and bring about an end to the industrial action, or risk rolling-back work done to recovering the NHS, or casting doubt on progress made to reform the service.

The NHS Confederation has now set out four key areas which it says are at risk.

1) Elective recovery

Health leaders are currently expected to meet the Government target to offer an elective procedure to everyone who has been waiting more than 18 months for one by 1 April.

But this has become increasingly challenging, the Confederation has said, with more than 10,700 operations postponed as a direct result of strikes so far.

2) Reform

Industrial action will also impact the wider Government ambition to transform the NHS.

Leaders in all ICB areas have already begun introducing virtual wards, for example, but the Confederation has said more time is now being spent ‘fire-fighting’ immediate pressures. Senior staff have said they have been agreeing derogations for two weeks in advance of strikes.

3) Staff relationships

There is also a risk tensions between local staff could escalate as strikes continue, it warned.

Staff relations have remained positive during the strikes, including in instances of derogations and where staff must cross the picket to provide necessary care.

4) Patient access

Leaders of mental health providers have warned that patients could store up more serious health concerns.

As occurred during the pandemic, health leaders have reported that pressure facing the NHS can deter patients from coming forward to access care. This in turn can lead to more complicated cases presenting later on during the service’s recovery, the Confederation suggested.

Matthew Taylor, chief executive of the NHS Confederation, said: ‘We face a hugely disruptive week for patients and the government cannot afford to let this escalate any further. We urge ministers to take the first step and find a resolution to this deadlock with the unions.

‘It is not only the disruption on the day that is a cause of worry but the longer-term damage on service delivery, staff morale, reform, and how the public engages with the NHS too. As there appears to be no end to industrial action in sight and with at least 10,700 elective procedures having had to be cancelled already because of the strikes, health leaders fear a further escalation will only make the NHS’s recovery even harder.’

Strikes are expected to continue on the following days:

  • Tuesday 7 February: Nurses (RCN)
  • Friday 17 February: Ambulance workers (Unite)
  • Monday 20 February: Ambulance workers (Unite and GMB)
  • Wednesday 22 February: Ambulance workers (Unite)
  • Monday 6 March: Ambulance workers (Unite and GMB)
  • Monday 20 March: Ambulance workers (Unite and GMB)

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