THOUSANDS of nurses across England, Wales and Northern Ireland have begun a 12-hour strike in a dispute over pay.

The strike is the biggest by nurses in the history of the NHS, involving around a quarter of hospitals and community teams in England alongside all trusts in Northern Ireland and all but one health board in Wales.

This comes after nurses from two unions in Scotland voted to accept the increased pay offer put to them by the Scottish Government.

Strikes which were set to hit the Scottish Ambulance Service and the wider NHS are now off.

Picket lines have been set up at dozens of hospitals elsewhere in the UK. Major trusts taking part include Guy’s and St Thomas NHS Foundation Trust in London, Addenbrookes Hospital in Cambridge and University Hospitals Birmingham NHS Foundation Trust.

The National: RCN members on a picket line in NewcastleRCN members on a picket line in Newcastle (Image: RCN members on a picket line in Newcastle)

Saffron Cordery, interim chief executive of NHS Providers, said NHS trusts were “pulling out all the stops” to lessen the impact on patients.

She added: “The cold snap has ramped up demand that was already at or close to record levels, but on strike day NHS trusts will do everything they can to ensure that essential services are properly staffed and patient safety, always the number one priority, is safeguarded.”

RCN chief executive Pat Cullen has accused Health Secretary Steve Barclay of “belligerence” after he refused to discuss the issue of pay.

He has said the Government is sticking to the recommendations of the independent pay review body, which said nurses should get a pay rise of around £1400.

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

In Scotland, RCN members are being consulted on a revised pay offer from the Scottish government.

Health minister Maria Caulfield said around 70,000 appointments, procedures and surgeries will be lost in England due to the strike. Thousands more will be affected in Northern Ireland and Wales.

She told Sky News: “Cancer surgeries are going to be closed in those 44 trusts in England. We reckon it’s about 70,000 appointments, procedures, surgeries that will be lost.”

The health service will be running a bank holiday-style service in many areas, though the Royal College of Nursing (RCN) has said it will still staff chemotherapy, emergency cancer services, dialysis, critical care units, neonatal and paediatric intensive care.

Some areas of mental health and learning disability and autism services are also exempt, while trusts have been told they can request staffing for specific clinical needs.

When it comes to adult A&E and urgent care, nurses will work Christmas Day-style rotas.

Cullen said on Thursday morning there is “nothing independent” about the independent pay review body process as she suggested future strikes are likely.

“This is a tragic day for nurses, a tragic day for patients… and it’s a tragic day for the people of society and for our NHS,” she told BBC Breakfast.

The National: RCN General Secretary Pat Cullen (second left) with RCN members on the picket line outside St Thomas' Hospital in LondonRCN General Secretary Pat Cullen (second left) with RCN members on the picket line outside St Thomas' Hospital in London (Image: PA)

“And it’s tragic that this government has decided not to speak to us, talk to us, get into a room on the first day of strikes, and that’s why we’re here today.”

She said nurses were asking for the “20% that has been eroded from our nurses’ pay over the last decade to be put back”, adding that “hundreds of nurses” are leaving the profession every day.

She said Barclay had told her she could talk about “anything but pay – that’s going to resolve nothing. What it is going to do is to continue with days like this.”

Cullen said the independent pay review body was “set up by Government, paid by Government, appointed by Government and the parameters of the review are set by Government, so there’s nothing independent about it, and that’s why they came up with the 3% that they’ve come up with.

“There’s nothing independent about the independent pay review body – it might be accepted by Government, it’s not accepted by the Royal College of Nursing.”

Earlier, Caulfield said pay is “almost a smaller issue” than other conditions for nurses.

READ MORE: Nicola Sturgeon hailed for nurses' pay talks as England strikes begin

She said: “Pay is an issue. When I was working full time, I went through the pay freeze and the pay cap, which were very difficult. That’s when we had the Lib Dem coalition government and they were difficult times.

“But the bigger issues I see from colleagues are around sometimes long working hours, not finishing on time, not having protected study time like doctors do, or trying to get the right skill mix in your working environment so patient workload is manageable.

“So pay is an issue but it’s almost a smaller issue compared to some of those others.”

On the picket line outside St Thomas’ Hospital in Westminster, some nurses were wearing white RCN vests with the slogan “The Voice of Nursing”, while others clutched placards with messages such as “It’s time to pay nursing staff a fair wage”.

One nurse called Sarah said her niece, a newly-qualified nurse, had witnessed new nurses being left in charge of 48 patients on a ward.