Paramedics and other ambulance workers are set to strike, as patients face a mounting NHS crisis in the run-up to Christmas.
On Tuesday night, Unison, the union that represents hundreds of thousands of health workers, including ambulance staff as well as porters and cleaners, announced that 80,000 of its members had backed taking industrial action.
GMB - the largest union for ambulance staff - is also expected on Wednesday to declare its members have voted overwhelmingly in favour of walk-outs. It would be the first national ambulance strike for more than 30 years.
Unions are obliged to give two weeks’ notice of industrial action, meaning walk-outs affecting ambulance services could take place next month - while the nurses' strikes are already scheduled for December 15 and 20.
On Tuesday night, the Royal College of Nursing (RCN) announced that up to 100,000 nurses will join walkouts in 76 locations.
Altogether, 200,000 health workers are now understood to be backing strikes.
It comes amid a growing crisis in emergency care services, with average waits of an hour for heart attack victims, and ambulances now spending a quarter of their time in handover queues.
Health and defence officials are currently working on contingency strategies that could involve the military being drafted in to drive ambulances and stand in for front-line hospital workers.
The Department of Health and Social Care has yet to apply to use military aid.
Such measures would involve soldiers, who accepted a pay rise of 3.5 per cent, standing in for ambulance workers who rejected a 4 per cent increase.
On Tuesday night, Unison said that members including 999 call handlers, ambulance technicians and paramedics in the North East, North West, London, Yorkshire and the South West had backed strike action. It affects five out of the ten ambulance trusts and three other NHS employers.
However, only 80,000 out of 350,000 members voted in favour of industrial action and the union fell short of the 50 per cent support needed to trigger strikes in many areas.
Christina McAnea, Unison general secretary, said: “The decision to take action and lose a day’s pay is always a tough call. It’s especially challenging for those whose jobs involve caring and saving lives.
“But thousands of ambulance staff and their NHS colleagues know delays won’t lessen, nor waiting times reduce, until the Government acts on wages.”
On Tuesday, the RCN announced that walkouts will go ahead in 52 locations in England - around half of those which voted in favour - as well as all NHS employers in Northern Ireland and all bar one in Wales.
Great Ormond Street, Alder Hey children’s hospitals and leading cancer centres the Royal Marsden and Liverpool’s Clatterbridge are involved in the action, along with major hospitals across the country.
Emergency care will continue to be provided during the strike action.
The strikes at hospitals across England, Northern Ireland, and Wales are likely to mean thousands of operations cancelled, with discussions later this week to decide whether lifesaving services such as chemotherapy will be halted.
The nurses’ union said it would extend the action to more NHS organisations in January, unless negotiations are held.
No nurses strikes are currently planned for Scotland, where negotiations are ongoing.
Pay rise 'obviously unaffordable'
Rishi Sunak, the Prime Minister, has said the demands from the RCN for a 19 per cent pay rise are “obviously unaffordable”.
The RCN says that experienced nurses are worse off by 20 per cent in real terms due to successive below-inflation awards since 2010.
On Tuesday night, Pat Cullen, RCN general secretary and chief executive, said: “Ministers have declined my offer of formal pay negotiations and instead chosen strike action. It has left us with no choice but to announce where our members will be going on strike in December.
“Nursing is standing up for the profession and their patients. We’ve had enough of being taken for granted and being unable to provide the care patients deserve.
“Ministers still have the power and the means to stop this by opening negotiations that address our dispute.”
During Britain’s last national ambulance strike, in the winter of 1989/90, the Army was drafted in, along with volunteer drivers, and police.
The industrial action began with an overtime ban, with measures ratcheted up, so that ambulance crews were restricted to emergency 999 calls.
No strike in Scotland
Last week, GMB Scotland announced the suspension of strikes which had been due to start on Monday while the union consulted with members over a 7.5 per cent pay offer from the Scottish Government.
It comes amid a fresh wave of strikes on Wednesday by Royal Mail workers, university lecturers and sixth-form college staff, in one of the biggest walkouts so far to coincide.
Members of the Rail, Maritime and Transport union at Network Rail and 14 train operators are also planning 48-hour strikes on December 13 -14 and 16-17, and January 3-4 and 6-7, as well as an overtime ban over Christmas.
Commenting on the RCN announcement, Steve Barclay, the Health Secretary, said: “I am hugely grateful for the hard work and dedication of nurses and deeply regret some union members will be taking industrial action.
“These are challenging times for everyone and the economic circumstances mean the RCN’s demands, which on current figures are a 19.2 per cent pay rise, costing £10 billion a year, are not affordable.
“Our priority is keeping patients safe. The NHS has tried and tested plans in place to minimise disruption and ensure emergency services continue to operate.”