A <a href="https://www.thenationalnews.com/world/uk-news/2023/03/16/nhs-nurses-win-5-pay-offer-as-strikes-suspended/" target="_blank">nursing</a> strike involving staff in emergency departments, intensive care units and cancer care for the first time will present “serious risks and challenges", according to an NHS boss. Members of the Royal College of Nursing will walk out for 48 hours from 8pm on April 30 after rejecting the government's pay offer. Members voted against a pay deal of 5 per cent for 2023-24 and a one-off lump sum by a margin of 54 per cent to 46 per cent. The <a href="https://www.thenationalnews.com/world/uk-news/2023/04/14/nurses-could-strike-again-if-rcn-members-vote-to-reject-pay-deal/" target="_blank">offer was accepted by Unison staff on Friday</a>. Sir Julian Hartley, chief executive of NHS Providers, which represents workers in the health service, said the strike would mark an "unprecedented level of action". It comes as around 47,000 <a href="https://www.thenationalnews.com/world/uk-news/2023/04/10/nhs-leader-warns-of-catastrophic-consequences-on-healthcare-from-junior-doctors-strike/" target="_blank">junior doctors</a> finished their 96-hour strike in a separate dispute over pay at 7am on Saturday. Sir Julian told the BBC consultants and other staff filled the gaps created by the junior doctors’ strike, but if nurses went ahead with their walkout it may be more difficult to deal with. He said: "With nursing staff, obviously that represent a significant proportion of the workforce, taking action in those areas as well that will present an unprecedented level of action, that we haven't yet seen from nursing staff and therefore the challenges with that, the organisation and all the work that go into managing and mitigating that will be enormous.” Asked whether the <a href="https://www.thenationalnews.com/world/uk-news/2023/01/17/nurses-strike-dates-next-month/" target="_blank">RCN </a>would consider coordinating industrial action with junior doctors, the union's director for England Patricia Marquis told BBC's <i>Newsnight</i>: "That is something that will have to be considered if not least because we are all in the same space. "We all work in the same places and therefore there may be an issue where our strikes do at some point either would mark an "unprecedented level of action". "We are having conversations with the BMA [British Medical Association], not specifically around coordinating but more to understand what their asks are, what our asks are and also to understand how we can both work in a coordinated way, not necessarily on strike action but really to get the government to understand how just how difficult the situation is for staff in the NHS and the impact it's having on patients every single day." <a href="https://www.thenationalnews.com/world/uk-news/2023/02/04/union-chief-urges-prime-minister-rishi-sunak-to-help-end-nurses-strike/" target="_blank">RCN general secretary Pat Cullen</a> has written to Health Secretary Steve Barclay to seek an urgent reopening of talks with the government. She said: "What has been offered to date is simply not enough. The government needs to increase what has already been offered and we will be highly critical of any move to reduce it. "After a historic vote to strike, our members expect a historic pay award." Mr Barclay said it was "hugely disappointing" that the RCN had rejected the pay deal. He said: "Their decision to escalate strike action with no exemptions, based on a vote from a minority of members, is also hugely concerning. "The NHS staff council, which recommended this offer, covers a number of trade unions who are continuing to vote, and I hope this offer secures the support of a majority of members." Chancellor Jeremy Hunt said strikes would have an impact on efforts to bring down NHS waiting times. He said: "It is very challenging in the NHS anyway, but if you add the pressure of strikes on to what is already a very pressured service, it makes it very difficult to bring down waiting times and we're dealing with a record high in waiting times after the pandemic." <a href="https://www.thenationalnews.com/world/uk-news/2023/01/18/nurses-stage-second-strike-in-uk-as-patients-warned-of-inevitable-impact/" target="_blank">The RCN </a>will re-ballot its members in England to see if they want to continue taking industrial action because the current mandate runs out in early May. Unite and the GMB trade union will announce the result of their ballots on the same deal in two weeks.