More than 400 NHS theatre staff across four Greater Manchester hospitals are planning fresh strike action later this month after overwhelmingly rejecting their employer's latest pay offer.

UNISON members at the Northern Care Alliance (NCA) are planning a 24-hour strike on Wednesday 18 November, a 48-hour strike starting on Monday 23 November and a further 24-hour strike on Friday 27 November. The staff — nurses, clinical support workers and housekeepers — work at Salford Royal Hospital, Royal Oldham Hospital, Rochdale Infirmary and Fairfield General Hospital in Bury.

Last week, union members voted by 99% on an 83% turnout to reject the trust's latest offer, the first concrete proposal from the NCA to end the dispute. Staff have already walked out for 17 days over a five-month period.

What the dispute is about

The row centres on the use of NHS Professionals, an NHS-owned agency, to manage overtime. UNISON says the arrangements mean staff are paid less than the nationally agreed rates set out in the Agenda for Change agreement when they cover staff shortages, with some workers losing up to £80 per overtime shift.

According to the union, the rejected offer would have given workers enhanced overtime pay rates, but only for 12 months, before returning to management's new, lower-paid system. UNISON North West regional organiser Kevin Dolan said: "The union is writing to NCA immediately to make clear workers will carry on striking until they get fair pay."

The trust has said its offer included enhanced NHS Professionals bank rates for eligible theatre staff working additional voluntary shifts, guaranteed for 12 months, while it works on longer-term improvements to staffing, rotas and working conditions. The union has said workers are unlikely to accept any future proposal that involves a third party managing overtime payments.

Impact on patients

The dispute is already affecting patient care. Figures from the Northern Care Alliance showed that 12 of the 28 incidents involving treatment delays between 1 July and 30 September were directly attributed to strikes by theatre staff. The trust has said between 120 and 130 treatments are cancelled for each day of industrial action, including cancer treatment.

The NCA was formed on 1 October 2021, bringing together Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust. It is operating under enforcement undertakings from NHS England, and a recent Care Quality Commission inspection of surgical services at Salford Royal identified 12 breaches of legal regulations, including on staffing, safe care and governance.

UNISON said the dispute would continue until staff are paid fairly for overtime worked. The union has also pointed out that critical care staff at the same trust won recognition of their contractual overtime rate in July after a similar campaign, and theatre staff are seeking the same outcome.