Strike action and winter pressures leave NHS in ‘vicious cycle’, leader warns

Continued strike action plus winter pressures are jeopardising the ability of the NHS to break out of a “vicious cycle”, a health leader has said.

Matthew Taylor, chief executive of the NHS Confederation, urged ministers to renew pay talks with trade unions in a bid to halt further industrial action.

He suggested waiting lists are likely to remain stubbornly high unless the Government gives the “NHS a fighting chance”.

Thousands of nurses from more than 55 NHS trusts in England are going on strike this Wednesday and Thursday, following two strikes in December.

The Royal College of Nursing (RCN) has also announced that two more, bigger strikes will be held next month.

The GMB union is expected to announce further ambulance worker strike dates this Wednesday, while junior doctors are also preparing to walk out.

In comments shared exclusively with the PA news agency, Mr Taylor said the NHS is trapped in a vicious cycle brought about by extreme pressures in emergency care, ongoing high levels of flu, Covid and respiratory infections, plus industrial action.

He said: “We’re now in the sixth week since strike action began and appear no closer to a solution.

“At the same time, the NHS continues to grapple with extreme pressure on its emergency care services and it is having to reschedule operations and outpatient appointments due to the strikes.

“We’ve been saying for weeks that the strike action couldn’t have come at a more difficult time for the NHS, but we hoped a compromise would be reached by now to bring an end to the impasse.

“All the while this continues, the NHS won’t be able to break out of the vicious cycle it’s in.

“There is some pessimism about the current state of the NHS, but local services have been making serious inroads into reducing waiting lists.

“NHS leaders know they face huge challenges in responding to the growing demand they are facing, but they need help from the Government in bringing an end to the dispute.

“If there is no realistic prospect of a solution, then we’re facing the prolonged war of attrition between the Government and the unions that we’ve been fearing.”

He said the NHS “has coped admirably on strike days” but the Government and unions need to find common ground quickly “for the benefit of patients”.

He said: “The good news is that there appears to be desire on both sides to reach a compromise and, in the meantime, the NHS is working hard with union representatives and others to ensure the most critical services continue to be provided and are minimising disruption.

“But elective procedures and check-ups are still having to be rescheduled and this is doing nothing to help the NHS meet its challenging targets.

“Ahead of the next round of strikes, our message to the Government is to give the NHS a fighting chance and do all you can to bring an end to this damaging dispute.

“The Prime Minister must not allow the stand-off in the wider public sector to hold back a deal being reached in the NHS.”

According to the NHS Confederation, which represents NHS organisations, NHS trusts must be able to tackle the immediate demand for emergency care alongside the waiting list for treatment, which currently stands at around seven million people.

NHS leaders fear there will be a “cumulative impact” of each additional strike day, it said, with more operations and outpatient appointments having to be rescheduled.

Calculations suggest that if this week’s nursing strikes match the same level as December, then more than 4,500 operations will be cancelled alongside 25,000 cancelled outpatient appointments.

This is on top of December cancellations and would take the total to around 10,000 cancelled operations and more than 50,000 cancelled outpatient appointments, according to the NHS Confederation.

The warning comes after MPs voted in favour of the Government’s minimum service levels bill aimed at curtailing the impact of strikes.

The Strikes (Minimum Service Levels) Bill was backed by 309 votes to 249 in a vote on Monday night – a majority of 60.

The Bill would require minimum levels of service from ambulance staff, firefighters and railway workers during industrial action, although unions and opposition MPs have condemned the proposals as unworkable.

Elsewhere, the NHS has reminded patients to attend appointments and seek urgent care even while strike action is ongoing.

NHS England said patients should use services “wisely” by going to NHS 111 online but continuing to call 999 in a life-threatening emergency.

NHS deputy chief nursing officer Charlotte McArdle said: “The NHS has tried and tested methods in place to manage any disruption and has been working hard to minimise the impact for patients.”

The RCN has been calling for a pay rise at 5% above inflation, though it has said it will accept a lower offer.

Inflation was running at 7.5% when it submitted the 5% figure to the independent pay review body last March.

But inflation has since soared, with RPI standing at 14% in November.

Health and Social Care Secretary Steve Barclay said: “Patients will understandably be worried by the prospect of further strike action by nurses – the previous two days of nurse strikes saw around 30,000 elective procedures and outpatient appointments cancelled.

“It is inevitable industrial action will have an impact on patients.

“I have had constructive talks with the Royal College of Nursing and other unions about the 2023/24 pay process and look forward to continuing that dialogue.”

Professor Alison Leary, chairwoman of healthcare and workforce modelling at London South Bank University (LSBU), said: “The healthcare system both in hospital and the community is under severe stress and so is the workforce.

“The fact that the RCN for the first time its history has called a series of nationwide strikes is a clarion call that there are serious issues.

“This industrial action is not simply about pay but also issues such as persistent understaffing and patient safety.”