Trust bosses fear fallout of co-ordinated strikes

The concerns were raised after the Royal College of Nursing confirmed members at various trusts had voted in favour of unprecedented action last week, with Unison and a raft of other unions also balloting members on strike action this month and in December.

Unison told HSJ co-ordinated action between itself, the RCN and the other health unions was “the best way to ensure industrial action is effective”.

One senior trust leader said that while the RCN strike days would prove a major challenge, they predicted their trust would be able to cope with the fallout. But they said the challenge would get even “more hairy” if Unison members also walked out on the same dates – a prospect they feared likely.

The senior NHS figure said: “We are planning for the two days of [RCN] strikes… I’m confident we’ll manage it, [but] I’m not sure how we’ll manage it if [a] Unison strike joins with it, and we’re pretty confident Unison’s strike will join with it. Then that’s going to get more hairy.”

Another trust leader agreed the likelihood of wider industrial action beyond the RCN would pose an even greater challenge – and even the prospect of industrial action beyond the health and social care workers.

“The wider impact is also about the wider industrial action. If local authorities go out, if social care go out, if teachers go out, the impact there will be significant too. So it’s the knock-on impact that will be a real challenge for us and we’ll be dealing with it for much longer than the industrial action,” the source said.

HSJ also understands that trust bosses have concerns about what will and won’t be classified as urgent and also about the emergency work to be carried out throughout a strike.

One senior provider figure used the example of insulin injections, which are at present to be part of the urgent and emergency care activities to continue throughout a strike, and wound treatment services, which, at this stage, are not.

They said: “If people don’t get those [insulin] injections twice a day, that person, by the end of 24 hours, will be in hospital [but] we are negotiating on [other areas] for example wound care. If you don’t dress people’s wounds at the right time, the worst situation is that a [deteriorating] wound means your leg has to be chopped off. At the moment, doing wound care is not being considered urgent care.”

Unison will ballot 350,000 members across the NHS this month, with ballots being held in England and Wales on 25 November.

The union represents a wide range of staff working in the NHS, including porters, nurses, paramedics and cleaners. Its leadership has already recommended “members vote ‘yes’ for strike action in order to pressure government decision makers to increase pay”.

Meanwhile, GMB Union is balloting more than 15,000 ambulance workers across 11 trusts in England and Wales for strike action. The ballot opened on 24 October and closes on 29 November. Any potential strike action could take place before Christmas.

Other unions balloting for strike action include the Chartered Society of Physiotherapy, which is also balloting its members in England and Wales on pay for the first time in its more than 100-year history. The CSP ballot, however, does not close until in mid-December.

Unison’s head of health Sara Gorton said: “Working with other health unions holding strike ballots is the best way to ensure industrial action is effective. Some might back action within the same employer, increasing any disruption.

“The thresholds for a strike are incredibly high, but a strong yes vote is the best way to jolt complacent ministers into investing in the future of the NHS.

“It’s not too late. The government can do the right thing by giving nurses, healthcare assistants, paramedics, 999 call handlers, occupational therapists, porters, cleaners and all the other NHS staff the second pay rise they need.”

She added: “The ball is in the government’s court. Ministers must boost pay to avert strikes this winter and stem the tide of employees leaving the NHS.”