Thousands of nurses across England, Wales and Northern Ireland have begun a 12-hour strike in a bitter 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.

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.”

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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.

Picket lines have been set up at dozens of hospitals. 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.

Saffron Cordery, interim chief executive of NHS Providers, told the PA news agency NHS trusts were “pulling out all the stops” to lessen the impact on patients.The Northern Echo:

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 £1,400.

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

The Northern Echo:

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

Ms 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.

“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 Mr 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.”

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

The MP, who said she still does shifts as a nurse as in an RCN member, told Times Radio it was “with regret” that nurses are walking out.

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.

A growing number of other workers are also going on strike in disputes over pay, jobs and conditions, with an ambulance worker strike scheduled for next week.

Midwives and maternity support workers in Wales have voted to strike, though the ballot in England did not meet the legal turnout threshold.

Rail services were crippled on Wednesday because of a walkout by members of the Rail, Maritime and Transport union, with more stoppages planned in the coming weeks.

The Communication Workers Union is embroiled is a bitter row with Royal Mail which has led to a series of strikes, with more planned in the busy run-up to Christmas.

Other workers planning strikes include Border Force officers and staff in government departments.

On Wednesday evening, Mr Barclay said nurses were “incredibly dedicated to their job” and “it is deeply regrettable some union members are going ahead with strike action”.

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Pressure has been mounting on the Government find a compromise on pay, with former Conservative Party chairman Sir Jake Berry saying it “is going to have to improve its offer”.

“We need to find a way as a Government, and the union does too, to get to that centre point, that point of agreement straight away,” he told Talk TV.

Elsewhere, former head of the independent pay review body, Jerry Cope, suggested ministers should ask it to reconsider the pay rise recommended before inflation soared as a possible solution to strikes.

He told BBC Radio 4’s Today programme the decision “took place in February and the world was a rather different place in February”.