MIDWIVES across the region will strike for the first time on Monday as part of industrial action by up to nine health unions after most NHS staff were denied a one per cent pay rise.

During the four hour strike between 7am and 11am members of the public in the North-East and North Yorkshire have been urged not to call 999 for an ambulance unless it is a serious or life-threatening emergency.

Picket lines are expected outside hospitals across the region and some patient appointments have been cancelled.

But despite the national strike - expected to involve up to 500,000 staff - A&E departments and maternity units will remain open.

A spokeswoman for the North East Ambulance Service said: “Patients in a life-threatening situation will still get an ambulance response but people with injuries such as minor breaks, women in routine labour or those involved in minor traffic accidents will be given clinical advice or told to make their own way to hospital.”

A spokeswoman for the Yorkshire Ambulance Service urged the public “only to use the emergency ambulance service in a serious or life-threatening emergency.”

The YAS has had to cancel journeys involving its Patient Transport Service for routine appointments at hospitals but is operating for patients with urgent medical needs.

A spokesman for County Durham and Darlington NHS Foundation Trust said: “We plan to be able to operate most services close to normal. Some appointments have been cancelled and rearranged.”

Chris Harrison, director of workforce at South Tees Hospitals NHS Foundation Trust said: “Initial feedback would suggest minimal disruption to services.”

Barbara Bright, from North Tees and Hartlepool NHS Foundation Trust said: “We have a good relationship with our unions and we are working with them to make sure we can reduce the effect of the strike as much as possible.”

Ruth Berkley, North-East spokeswoman for Unison, said: “There is a strong feeling among health workers that Jeremy Hunt, Secretary of State for Health, has treated them with complete contempt by refusing to implement the Pay Review Body recommendation on pay in the NHS. The miserly one per cent pay offer denies 60 per cent of NHS staff a pay rise this year.

Sue Cafferty, North-East regional officer for the RCM, said: “I never thought I would see us go on strike.”

Unison members will also be taking action short of a strike for the rest of this week, taking breaks and refusing to work unpaid overtime.

A spokesman for the Department of Health "We are disappointed that trade unions are taking industrial action and have rejected our proposals to give NHS staff at least one per cent additional pay this year and at least a further one per cent next year.

"NHS staff are our greatest asset, and we've increased the NHS budget to pay for over 12,500 more clinical staff since 2010. We cannot afford a pay rise in addition to increments - which disproportionately reward the highest earners - without risking frontline jobs.”