An Inside View at the Nurses' Strikes and Pay Freeze in the UK

Against the backdrop of rising living costs and mounting operational pressures, nurses and healthcare professionals have been pushed to their limits. In our latest blog, we are joined by Lucy Grimwade, who will provide us with an inside view into the issues surrounding the recent Nurses’ strikes and pay freeze that frontline nurses have been experiencing in the UK.

As an Advanced Clinical Practitioner based in the north of England, Lucy has a unique perspective on the current climate of the NHS and the challenges that healthcare professionals face every day.

Join us, as Lucy explains these issues in greater depth and sheds some light on the experiences of those on the frontlines of healthcare.

Q1: Lucy, could you describe the recent circumstances in the UK healthcare system that have led to the strikes and pay freeze?

A1: Since the middle of last year, we’ve seen things escalate in a way that I’ve never seen before. There are fewer staff, greater staff turnover, and more staff members who are ill, which has led to unprecedented sickness rates. 

On top of that, we’re seeing more and more patients attending the emergency department every day. The department usually sees a maximum of 250-300 patients, but now we’re seeing 350-400 patients with only 24 beds available. 

It feels worse than when we’ve had previous periods of what was considered extreme. Previous corridor care that was deemed completely unacceptable now seems to have crept back in, and patients are being held in every available space, including in ambulances. The increasing acuity of patients has been a constant challenge for us.

Q2: In your opinion, how is the current strike action different from previous strikes that you may have heard about in the past?

A2: To be honest, my awareness, involvement, and engagement in previous strikes were non-existent. I can recall in 2014, Unison Nurses went on strike, but I can’t remember ever thinking about strikes. 

However, I think this strike action is in part a culmination of desperation – it’s a sad situation. Pay, staffing, resources, morale, care, and dignity all seem to be at an all-time low. This strike initially seemed to have much more drive than previous ones. It’s been heavily covered by the media, and the portrayal may have been slightly skewed in the underlying need and intention. 

Q3: Can you share your personal experience of working in the NHS and how the pressure has increased over the past few years?

A3: In my 14 years of nursing, I’ve never known it to be this bad. There have always been elements of pressure, such as 4-hour targets and breaches, and specific elements of patient care like pressure ulcer management or falls, which seemed manageable and more role-specific. But now, everything seems to be everybody’s problem. 

It’s unclear whether the constant media coverage makes it feel more overwhelming or apparent, or whether it’s the fact that the pressure literally extends through already exhausted senior teams that previously may have been better equipped and resilient in disseminating the concerns that were possibly not necessarily shared. 

Then, we had the pandemic, which brought its own pressures with all the new and unknown elements of that. 

Q4: Can you speak to the disappointment and frustration that some of your colleagues may have felt about not being able to strike due to not meeting the 50% threshold?

A4: Yes, there was a real sense of disappointment among my colleagues who were unable to strike because our trust did not meet the 50% threshold. It felt like we were not allowed to have our say, and that our votes didn’t matter. It was also frustrating to realise that even if we had met the threshold, we would not have been able to strike due to minimum staffing and safety needs. 

As an emergency department, we can’t simply close our doors when we’re full. We continue to accept patients even as the risk and pressure mount, and it can be very tough to provide the level of care that we want to deliver under these conditions.

I’ve spent only 1-hour on the picket line at another hospital and the degree of comradery was great! There was a true sense of unity & inclusivity, It didn’t matter where we worked, what our day job entailed, we were nurses. 

Q5: What are some of the specific issues you’ve seen in patient care within the emergency department?

A5: There are several granular front-end issues that have been observed in patient care within the emergency department. Firstly, the public’s attitude and expectation on staff are major issues as people have no real appreciation of how departmental pressures directly impact them. Patients who arrive by ambulance expect to be seen as a priority despite limited capacity. 

Secondly, basic patient care is compromised due to the lack of facilities, such as toilets, washing areas, and dressing areas. 

Thirdly, there is a shortage of physical trolleys, with elderly patients often left waiting in uncomfortable chairs for up to 20 hours. 

Fourthly, there are shortages of essential resources such as linen and oxygen. Additionally, nurses are often forced to prioritise patients, sacrificing some patients’ needs for the sake of others. 

Other issues include determining priorities and managing risks, staff burnout, and friction between ambulance staff and emergency department staff when holding crews.

Q6: Is there a direct relationship between the cost of living crisis and the spike in demand for healthcare services?

A6: There may not be a direct quantifiable relationship between the cost of living crisis and the spike in demand for healthcare services, but it is possible that there could be a correlation. 

High acuity patients have been observed, but it is uncertain if their acute presentations are a direct consequence of the cost of living crisis. However, there has been an increase in social care referrals and safeguarding for patients who have no heating or lack a safe discharge plan. 

Mental health presentations have also increased, and there has been a surge in 111 referrals, with patients being unable to access GP/community services and advised to attend ED. Delays for beds outside the ED are unprecedented, with waits of 24-30 hours being common. 

The cost of living crisis has also added to the stress on staff, who have to work extra shifts to make ends meet and some even rely on food banks.

Q7: What is the overall morale of healthcare workers at the moment?

A7: Healthcare workers are experiencing a range of emotions, from exhaustion and burnout to frustration and anger. Many feel that their efforts and sacrifices during the pandemic have gone unappreciated and that there are limited incentives or investment opportunities for staff. Goodwill, which has often fueled the NHS in times of need, is dwindling. Staff turnover is high, and many are using food banks to make ends meet. Despite this, healthcare workers continue to do their best to provide quality care to their patients.

Q8: What do you foresee as the mid-term future in healthcare?

A8: Lucy believes that the mid-term future of healthcare looks rocky. She suggests that the outcome of the strikes will determine whether there will be any welcomed changes to the current situation. The current state of healthcare is not sustainable, and changes will be necessary to keep teams and services running.

END 

Thank you to Lucy Grimwade for joining us and sharing her insight into the current Nurses’ strikes and pay freeze in the UK healthcare system. Please feel free to leave a comment below to let us know your thoughts and to add any insights from your experiences.