Prime Minister Rishi Sunak has said pay demands from unions representing nurses are ‘not affordable,’ as the threat of strike action that will hit operations and appointments looms.Mr Sunak said he shared the public’s ‘respect and gratitude’ for nurses, and that he was pleased the Health Secretary was meeting unions to resolve the issue.Steve Barclay earlier said discussions with Royal College of Nursing (RCN) general secretary Pat Cullen, the union leader behind the industrial action, were ‘constructive’ and his focus was on patient safety and minimising disruption. The unions are asking for a 17% pay rise, and I think most people watching will recognise that clearly that’s not affordablePrime Minister Rishi SunakBut he was understood to be resistant to negotiating on pay, with the union demanding an increase of at least 15% compared with the £1,400 rise awarded earlier this year.Speaking at the British-Irish Council summit in Blackpool, Mr Sunak told broadcasters: ‘I absolutely share everyone’s respect and gratitude for our nurses, for the dedication and the hard work that they provide for all of us.’And I think where we are now is, that the unions are asking for a 17% pay rise, and I think most people watching will recognise that clearly that’s not affordable.’And I of course recognise the challenges people face and the way that we resolve these situations is we have an independent body that makes recommendations to the Government and indeed the Health Secretary accepted those recommendations in full, and I’m pleased that he will be sitting down with the unions to see how we can resolve this.’The RCN announced on Wednesday that its members in the majority of NHS employers across the UK have backed industrial action.The health service will turn its attention to treating emergency patients in a ‘life-preserving care model’, with sources saying some hospitals on strike days will have staffing levels similar to those over Christmas.Some of the most serious cancer cases could still be treated, while urgent diagnostic procedures and assessments will be staffed if they are needed to gather data on potentially life-threatening conditions or those that could lead to permanent disability.After the meeting in Whitehall, Mr Barclay tweeted: ‘Nurses do an incredible job & I regret some union members have voted for strikes.’My priority is to keep patients safe and minimise disruption – my door is open & we have agreed to meet again shortly.’A Department of Health and Social Care source said they did discuss pay but that the Government position remained that they were ‘not negotiating’ as they try to stick to the NHS pay review body’s recommendation rather than the 5% above the rate of inflation that nurses are demanding.The talks instead were said to have focused on a ‘wide range of issues’ including patient safety and working conditions.’There was a willingness on both sides to engage on all those issues,’ they said.’Pay is going to be difficult, both sides set out where we’re at.’The RCN said the talks were a ‘cordial introduction that covered many important, broad topics’.’We await a future meeting to address the specifics of our dispute and the reality that our members have voted to strike,’ a statement added.Meanwhile, Labour leader Sir Keir Starmer said he supports the ‘right’ of the nurses to strike, but refused to commit to above-inflation pay rises for nurses if he was in No 10.’I completely empathise with the position that nurses are in,’ he told ITV News.’They’re working really hard in really difficult circumstances. Pay is an issue, numbers are an issue – if you ask anybody who works in the health service, and my wife does, the number one issue is we haven’t got enough people.’If and when we come into power, and I hope the sooner the better, we’re going to inherit a pretty awful economic situation after… this Tory Government has crashed the economy. So I don’t want to make promises I can’t keep.’Matthew Taylor, chief executive of the NHS Confederation, which represents most NHS organisations, said operations and appointments will have to be cancelled or postponed despite national and regional plans to minimise the impact.He said the RCN has promised to maintain emergency and critical care ‘but there will be an impact if there is industrial action in terms of cancelled appointments, cancelled procedures, and NHS leaders will do everything we can to minimise that and to ensure that patients are kept informed of what is happening’.Patricia Marquis, RCN director for England, told BBC Breakfast that current NHS services are ‘not safe’ and the Government has ‘failed to listen’ to what nursing staff have been saying.She said there are some services that need to continue during strike action to keep patients safe ‘and we will agree with employers what those are and which staff should be working’.Meanwhile, Saffron Cordery, interim chief executive of NHS Providers, said: ‘We completely understand how strongly they feel – below-inflation pay awards, rising cost of living… we’ve heard these tales of nurses resorting to food banks, many trusts are setting up school uniform banks, for example, to support nurses and others in the basic costs of living. We have to see the Government come round the tableSaffron Cordery, NHS Providers’We also have to remember that the NHS has been struggling for a long time in terms of staff shortages and workloads that have really been rocketing, so we understand the circumstances.’She urged ministers to talk to the unions to reach a resolution, adding: ‘We have to see the Government come round the table.’Industrial action is expected to be held before the end of the year at some of the UK’s biggest hospitals, including Guy’s and St Thomas’ opposite Parliament, the Royal Infirmary in Edinburgh, University Hospital Wales, and Belfast’s Royal Victoria.Other health worker unions including Unison and the GMB will announce the result of strike ballots before the end of the month among staff including ambulance drivers and paramedics, hospital porters and cleaners.Physiotherapists started voting on Monday over industrial action, while a ballot of midwives opens on Friday.The unions are protesting over a pay award earlier this year of £1,400 for most NHS workers, with the RCN calling for a rise of 5% above the rate of inflation.