The government has said it has contingency plans for dealing with a strike by nurses amid the growing threat of industrial action in the NHS.

The Observer revealed on Sunday that the biggest nursing strike in NHS history could take place before Christmas after “large swathes of the country” voted for nationwide industrial action. The Royal College of Nursing (RCN) is due to announce the results of its ballot in the next few days.

If strikes take place, they would affect nonurgent – not emergency – care, but could still cause disruption and present a major challenge to Rishi Sunak and Jeremy Hunt as they seek to fill a £50bn black hole in public finances.

Cabinet Office minister Oliver Dowden said that in the event of strikes, the NHS would prioritise the most essential services – although he acknowledged that it would have an impact on other activities, including elective surgery.

“We have well-oiled contingencies in place and the Department of Health is across how we would deal with a scenario like this should it arise,” he told Sky News’ Sophy Ridge On Sunday programme. “We will make sure we prioritise the most essential services – emergency services and so on. But of course there would be an impact as a result of a strike like that.”

Dowden urged nurses and others to reconsider going on strike, even if they supported industrial action in the ballot. “We have already agreed quite considerable support for nurses,” he said.

Union officials say that since the Conservatives took power in 2010, the pay of some experienced nurses has fallen by 20% in real terms. They are calling for a pay award of 5% increase plus inflation – a total of about 15%. But the government said the average basic annual pay for nurses would increase from about £35,600 to about £37,000 from March 2022, a rise of just 4%.

“Cutting nurses’ wages by 20% since 2010 is the opposite of providing ‘considerable support’ for nurses and the Cabinet Office minister shouldn’t insult our members by pretending it is,” said a spokesperson for the RCN, which had recommended to its 300,000 members that they strike. “The minister appears in denial about both the anger of nursing staff and the public support we have.”

The final results are being counted but RCN sources say a large majority of nurses have voted in favour of action over the pay dispute. The vote has been carried out as a series of individual workplace-based ballots and if action is not supported at a local level it is possible that those hospitals and services will not be affected by strike action. Health workers in several other unions, including ambulance staff, hospital porters and cleaners, have started to, or are about to, vote on industrial action.

A Department of Health and Social Care spokesperson said: “We value the hard work of NHS staff including nurses, and are working hard to support them – including by giving over one million NHS workers a pay rise of at least 1,400 this year as recommended by the independent NHS Pay Review Body, on top of 3% last year when pay was frozen in the wider public sector. Industrial action is a matter for unions, and we urge them to carefully consider the potential impacts on patients.”

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