Around 100,000 nurses went on strike on Tuesday for the second time in a week as their union issued an ultimatum to the government to respond to pay demands within 48 hours or face another round of industrial action in January.

Ambulance staff in England and Wales are set to follow suit on Wednesday and Dec. 28, leaving those with all but the most life-threatening conditions to make their own way to hospital.

"We cannot guarantee patient safety, we cannot avoid risks in the context of this industrial action," Matthew Taylor, chief executive of the NHS Confederation which represents national health service organisations, told BBC Radio.

"We are worried about the risks tomorrow but with the possibility of further strikes developing as winter unfolds ... we are entering into a very dangerous time. This is why we are upping even more our call to the government and to the trade unions to try to find a way of resolving this dispute."

The strike by nurses is unprecedented in the Royal College of Nursing (RCN) union's 106-year history, but it says it has no choice as the soaring cost of living leaves workers struggling to make ends meet.

The RCN says its members' real-term earnings have fallen by 6% in the last decade and has called for a pay rise of 5% above the RPI rate of inflation, which stood at 14% in November.

The government awarded nurses around 4% on average, on the recommendation of an independent pay review body, and has declined to discuss pay further. Prime Minister Rishi Sunak says the nurses' demands are unaffordable.

"I will negotiate with him at any point to stop nursing staff and patients going into the new year facing such uncertainty," RCN head Pat Cullen said.

"But if this government isn’t prepared to do the right thing, we’ll have no choice but to continue in January."

A YouGov poll published on Tuesday found two thirds of Britons support the nurses' strike, with 63% backing action by ambulance staff. The majority of those surveyed said the government was most to blame for the strikes.

"Our door is open to discuss with the unions anything relating to working conditions. What we can't do is go back into reopening the pay award," junior health minister Will Quince told Sky News.

CRITICAL INCIDENT

The strikes are putting extra pressure on healthcare provision in the state-funded National Health Service when it is already stretched by staff shortages and record backlogs due to COVID delays.

A hospital in southern England and the South East Coast Ambulance Service both said on Tuesday they had declared a critical incident due to extreme pressures on their services.

"Our members are tired of going to work every day and in some cases, spending the whole of their shift sat on an ambulance outside an A&E department with the same patient," Rachel Harrison, GMB union public services national secretary, told a committee of lawmakers.

"We've had examples where our members have clocked off at the end of one shift to return the following day to the same patient being on that ambulance."

The military have been put on standby to help drive ambulances and ministers are meeting with unions on Tuesday to discuss which emergencies ambulances will still respond to, amid media reports those suffering heart attacks or strokes might not qualify.