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NHS bosses have been warned to brace themselves for waves of strike action by more than 400,000 staff over pay.
Public-sector union Unison has written to the heads of more than 200 NHS organisations as health workers either began to vote on strike action or have set dates to do so.
They include paramedics, midwives, theatre staff, occupational therapists, porters and nurses.
Unison has also written to new Health Secretary Therese Coffey, urging her to meet and negotiate an improved pay award to avoid widespread disruption this winter.
The union said: “It’s now up to the government to avoid strikes in NHS by putting pay right.”
Unison is launching its own ballot of NHS workers on October 27.
They want an above inflation increase after years of pay freezes, below-inflation increases and real-terms wage cuts.
It comes as the Royal College of Nursing (RCN) launched a historic ballot for strike action over pay.
In its letter to Ms Coffey, the Unison said: “Taking industrial action is a very serious move.
“But having exhausted other routes to prompt the government into action, many are concluding that withdrawing their labour this winter is the best way to help patients.
“The record and mounting treatment backlog, alongside further Covid surges, flu and other pressures expected to hit hard this winter, mean the damaging impact of this workforce crisis can only escalate.”
Unison head of health Sara Gorton said: “A proper pay rise would help the NHS start tackling the growing staffing shortages hampering its ability to cut waiting lists and reduce ambulance delays.
“But disruption isn’t inevitable. Ministers could come up with a decent wage increase and a proper workforce plan. The ball is sitting in the government’s court.”
