Critical Incident Declared as Hundreds of NHS Staff Strike in Greater Manchester
The Northern Care Alliance (NCA) NHS Foundation Trust has declared a critical incident ahead of a three-day walkout by more than 350 operating theatre staff, a move that signals the scale of disruption facing four major hospitals in Greater Manchester.
Nurses, clinical support workers, and housekeepers from Salford Royal Hospital, Royal Oldham Hospital, Rochdale Infirmary, and Fairfield Hospital in Bury began industrial action on Monday, August 24, with further strikes planned for Wednesday, August 26, and Friday, August 28. The trust confirmed the critical incident declaration on Sunday evening, a step taken when hospitals face extreme pressure and cannot safely deliver all core services.
Root of the Dispute: Overtime Pay and NHS Professionals
The strike action centers on a long-running dispute over overtime payments. Trade union Unison claims that when staff cover shortages, they are contractually entitled to time-and-a-half pay. However, the trust's use of an outside agency, NHS Professionals (NHSP), to manage overtime has led to cases where staff earn less than they would on a normal shift, with some workers reportedly missing out on more than £80 per shift.
Kevin Dolan, Unison North West regional organiser, accused the trust of bad faith negotiations. "A deal was put on the table but taken away before we had chance to talk it over," he said. "We are ready to continue negotiations, but it's obvious NCA has no intention of resolving this. This isn't complicated. Staff are simply asking for what their contract says they're entitled to. Nothing more."
The union also claims that the trust initially tabled an offer to resolve the dispute but withdrew it before formal discussions could take place, a move that has deepened mistrust between staff and management.
Trust Response: Safety First, Apologies for Uncertainty
Gertie Nic Philib, chief people and strategy officer at the Northern Care Alliance, said the trust respected workers' right to lawful industrial action while emphasizing its commitment to patient safety.
"We have received formal notification that our theatre colleagues will be taking part in industrial action next week," Philib said in a statement. "We are preparing for this period of action and are working hard to minimise disruption to services and the patients who rely on our care."
Philib added that the trust would focus on maintaining safe services and ensuring that patients requiring urgent, emergency, and time-critical care continue to receive treatment. "We apologise for any uncertainty this may cause," she said. "People should be assured, that should any changes need to be made with their care, we would always contact them directly."
The trust has indicated that some planned appointments and treatments may be delayed or rescheduled, but affected patients will be contacted directly and do not need to call in to check.
Previous Industrial Action and Escalating Tensions
This week's strikes are not an isolated event. Staff at the NCA already took part in four days of strike action in June over similar concerns, and tensions have been simmering for months. The declaration of a critical incident — a formal status that allows the trust to request additional support from regional health authorities — underscores the severity of the situation.
The trust has faced significant criticism beyond the pay dispute. It has been under scrutiny over patient safety concerns, and the cumulative effect of repeated industrial action, staffing shortages, and morale issues has raised questions about leadership and governance within the organisation.
The NCA's decision to declare a critical incident just hours before the first walkout suggests that contingency plans may not be sufficient to cover the absence of such a large number of theatre staff. Operating theatre teams are essential not only for scheduled surgeries but also for emergency procedures, and any gaps in coverage could have serious consequences.
Broader Context: NHS Workforce Pressure and National Trends
The strikes in Greater Manchester are part of a wider pattern of industrial unrest across the National Health Service, driven by years of pay restraint, chronic understaffing, and increasing demand. While the specific dispute here concerns overtime payments, it reflects a deeper malaise: many NHS workers feel their contractual rights are being eroded, and that trusts are using external agencies to cut costs at the expense of staff wellbeing.
The use of NHS Professionals, a government-owned staff bank, is widespread, but this dispute highlights the tension between flexible staffing arrangements and workers' entitlements. For theatre staff, who often work long and unpredictable hours, the promise of premium pay for overtime is a significant part of their compensation. When that fails to materialise, the sense of betrayal is acute.
Financial Pressures and Staff Morale
The broader context is one of financial stringency. NHS trusts across England are under enormous budgetary pressure, and some have resorted to creative — but controversial — measures to manage costs. However, the union contends that the trust's approach is not only unfair but also counterproductive, as it risks driving experienced staff away from an already strained workforce.
"Those at the top of NCA have shown a lack of leadership and made their disregard for their staff clear," Dolan said. The comment reflects a growing sentiment among NHS workers that management priorities are misaligned with the realities of frontline care.
The declaration of a critical incident is a visible marker of how close to the edge the system has become. While the trust insists that emergency and urgent care will continue, the disruption to planned surgeries will inevitably extend waiting times — a political hot potato given the government's pledges to cut NHS backlogs.
What This Changes: Questions of Trust and Sustainability
This week's strikes and the critical incident declaration raise serious questions about the long-term sustainability of staffing models within the NHS, particularly in high-pressure environments like operating theatres. The dispute at the NCA is a case study in how breakdowns in communication and trust between management and staff can escalate quickly, with direct consequences for patients.
The Road Ahead
Negotiations between Unison and the NCA appear stalled, with the union accusing the trust of lacking intent to resolve the issue. If this pattern continues, further strike dates are likely. The trust, for its part, has committed to continuing constructive engagement, but the ball appears to be in management's court.
For patients, the advice is to attend appointments unless contacted directly. For the wider NHS, however, the implications are more troubling. The reliance on short-term fixes — like external overtime management — may save money in the immediate term but could cost far more in staff retention, patient trust, and operational stability.
As the NCA navigates this critical week, the eyes of the health sector will be watching closely. The outcome will not only affect thousands of patients in Greater Manchester but could also set a precedent for how other trusts handle similar disputes.
In a system already stretched to its limits, the difference between resolution and escalation could be measured in cancelled surgeries, longer waits, and further erosion of staff morale. For now, all sides say they are committed to patient safety — but the path to getting there remains unclear.
Related: Broader Challenges Facing the Region and Country
While this dispute unfolds in hospital corridors, other pressures continue to mount across Greater Manchester and beyond. The region has been grappling with infrastructure issues, such as the recent M62 Traffic Disruption: Crashes and Fire Cause Major Delays Across Greater Manchester and Yorkshire, which tested commuters and logistics alike. Meanwhile, systemic issues in education, like the GCSE English Resit Crisis: 39,000 Pupils Failed Due to Marking Variability, point to wider strains on public services.
The NCA's struggles are, in many ways, emblematic of a public sector under sustained pressure, where every strike, every critical incident, and every delayed procedure chips away at the promise of reliable, universal care. The hope is that this week's action — and the trust's response — will lead to a swift resolution. But the deeper issues of funding, staffing, and morale will require far more than a quick fix to mend.
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