It will mark the first strike action in the Royal College of Nursing’s 106-year history. The union issued an ultimatum to Rishi Sunak on Wednesday, urging him to use the Autumn Statement to ‘signal a new direction’ to halt walkouts over pay.But Downing Street said that the 17 percent pay rise nurses were demanding would cost £9billion. The Prime Minister’s official spokesman said: ‘In the current climate that is simply not deliverable.’Industrial action is now due to start later this year at just over half of NHS employers across the UK.Staff at 311 organisations were balloted by the RCN and 176 voted in favour of striking. The remaining 135 organisations either did not reach the 50 percent turnout threshold for a valid ballot or voted against action.RCN general secretary and chief executive Pat Cullen said: ‘Anger has become action – our members are saying enough is enough.’The voice of nursing in the UK is strong and I will make sure it is heard. Our members will no longer tolerate a financial knife-edge at home and a raw deal at work.’The disruption will see staff provide only a Christmas Day level of service on strike days, and could continue until May 2023. They will continue with emergency and urgent care, but the walkouts mean thousands of planned operations and appointments are likely to be cancelled.Ms Cullen insisted the action was being taken ‘as much for patients as it is for nurses’.She said: ‘Ministers must look in the mirror and ask how long they will put nursing staff through this.’While we plan our strike action, next week’s budget is the Government’s opportunity to signal a new direction with serious investment. Critical care …dedicated nurses treat a seriously ill Covid patient (Image: Joe Giddens/PA)’Across the country, politicians have the power to stop this now and at any point.’ Rachel Power, chief executive of the Patients Association, said nurses had the right to strike.But she added: ‘We’re very concerned about patient safety while this goes on.’Also for those patients who have been waiting a very long time for their elective care and those undergoing treatment, or waiting for treatment.’We will be calling on the NHS to be very clear in their communications to patients about what’s going to happen.’ The RCN is demanding a pay rise of five percent above the RPI inflation rate, which currently stands at more than 12 percent.This is significantly higher than the average rise of 4.75 percent being given to NHS staff in England and Wales, with a guaranteed increase of £1,400 for the lowest paid.More than 300,000 RCN members were urged to vote in favour of strike action in the ballot.Health and Social Care Secretary Steve Barclay sought to reassure the public that the NHS had ‘tried and tested’ contingency plans to cope during strikes.He said: ‘We are all hugely grateful for the hard work and dedication of NHS staff, including nurses, and deeply regret that some union members have voted for industrial action.’These are challenging times, which is why we accepted the recommendations of the independent NHS Pay Review Body in full and have given over one million NHS workers a pay rise of at least £1,400 this year. This is on top of a three percent pay increase last year, when public sector pay was frozen, and wider government support with the cost of living.’Our priority is keeping patients safe during any strikes.’The NHS has tried and tested plans in place to minimise disruption and ensure emergency services continue.’Junior doctors, ambulance staff, midwives, hospital porters and cleaners are also expected to vote on whether to take action over pay, raising the prospect that up to a million staff could join walkouts this winter.The RCN said some staff are struggling to afford the fuel they need to get to work, while others are turning to food banks as the cost-of-living crisis bites.But Education Secretary Gillian Keegan on Wednesday claimed most nurses using foodbanks were only doing so because of a broken’relationship or boiler’.She said: ‘Quite often when you go to foodbanks, something will have happened. You know, something will have broken down – either a relationship or boiler, or anything. Usually they’re in an emergency situation.’Ms Keegan added: ‘I don’t think there’s any point in going on strike. I would urge the nurses to continue those discussions.’The ballot’s result came after data revealed NHS England employs 430 managers on salaries of at least £100,000, with some earning up to £260,000. Protest… NHS staff march to Downing Street (Image: Getty)The starting salary for a nurse in England is just over £27,000 a year. This is the bottom of pay band five of the NHS contract – known as the Agenda for Change.Other workers such as healthcare assistants, porters and cleaners are on lower pay bands.As part of the contract, staff are entitled to in-the-job pay increases within their pay bands.A nurse with four years’ experience would be expected to get close to £33,000 – the top end of pay band five.Specialist nurses, such as those with qualifications to treat cancer and diabetes patients, can get up to £47,000, while the most senior nurse consultants can earn almost £55,000.The Royal College of Nursing says the average pay for a full-time, established nurse was just over £32,000 last year, similar to the average salary across the economy.