A “CONSTANT cycle of national NHS pay strikes will continue for as long as it takes,” unions warned today, as tens of thousands of nurses and ambulance workers downed tools in the biggest-ever health service walkout.

The Royal College of Nursing (RCN), which began a 48-hour strike, said members at 73 health trusts across England withdrew their labour — a massive increase on the 44 that saw action in December’s first walkout.

Unite and GMB paramedics, call handlers and other staff at ambulance trusts also joined the massive industrial action, which NHS leaders said caused “huge disruption.”

Ahead of further strikes by physiotherapists on Thursday and ambulance staff — including Unison members — on Friday, union leaders urged Tory ministers to act on years of falling take-home wages, saying the situation is driving a worker exodus and endangering patient safety.

However, Downing Street repeated its stubborn refusal to reopen talks on 2022-23’s below-inflation 4.75 per cent salary deal, despite an improved offer from the Welsh Labour government late last week.

Friday’s proposal — an additional 3 per cent on top of this financial year’s deal, of which 1.5 per cent is a permanent increase — saw most health unions postpone yesterday’s planned walkouts west of the Severn Bridge, but Unite ambulance members were still out on strike.

General secretary Sharon Graham stressed the action went ahead because it would be “disingenuous for us to put an offer to pause the strike in the full knowledge it was going to get rejected, but we’re tantalisingly close to a deal in Wales.”

She contrasted progress in talks with the devolved administration there to Westminster’s approach, where Tory ministers “just always sing ‘la la la la la’ and hope that the year goes by and we will forget what’s happened.”

There “isn’t going to be any other way to end this dispute” until Prime Minister Rishi Sunak and Health Secretary Steve Barclay agree to talk pay for 2022-23 and not just for 2023-24, she said.

Saffron Cordery, deputy chief executive of NHS Providers, which represents health trusts, backed the call, telling Sky News that ministers must engage with unions on this year’s wages as health services face a “hugely disruptive week.”

RCN head Pat Cullen hailed nurses for “trying to bring their NHS back from the brink.”

Speaking at a picket line outside St Mary’s Hospital in Paddington, west London, she added: “They will continue to do this for as long as it takes for this government to actually wake up and listen to their voice on behalf of patients. 

“This government has chosen to punish nurses instead of getting round a table and talking to me about pay in the same way as they’ve done in Wales and Scotland.”

Walkouts north of the border have been avoided so far after SNP ministers upped their salary offer to 7.5 per cent before Christmas.

Labour accused the PM’s under-pressure administration of “sitting this one out” when it comes to negotiating with striking workers.

Party leader Sir Keir Starmer, who has himself faced criticism for refusing to commit to inflation-matching wage rises for public-sector workers should Labour win the next general election, said the strikes were a “badge of shame for the government.”

He added: “I think many people will be absolutely flabbergasted that the government is still sitting this one out, not showing any leadership in the middle of a cost-of-living crisis, making the situation much worse than it otherwise would be.”