The Northern Care Alliance (NCA) has announced a new package it says is designed to end a dispute with more than 350 theatre staff who walked out this week. The Trust described the offer as "strong and fair", with enhanced payments for extra shifts alongside improvements to staffing, rotas, management and working conditions.
Strike action and pay dispute
Theatre staff took strike action on Friday, October 2, and again on Monday, October 5, in an ongoing dispute over overtime pay. Trade union Unison has previously claimed that changes to overtime arrangements, specifically the use of NHS Professionals (NHSP) to manage additional shifts, meant some staff could earn less for an additional shift than before, with some workers missing out on as much as £80 a shift.
The NCA runs Salford Royal, Royal Oldham Hospital, Fairfield General Hospital and Rochdale Infirmary, and has faced concerns over staffing pressures and patient safety in recent months.
Details of the new package
Under the new package, eligible theatre staff working additional voluntary shifts during what the Trust called a "period of extraordinary pressure" will receive enhanced NHSP bank rates. The rates will vary depending on the staff member's grade, spine point and shift worked, with a further 14.1 per cent added once annual leave has been accrued.
The enhanced rates will be guaranteed for 12 months while the Trust works to address the "underlying causes" of pressures affecting theatre services. The package also establishes a dedicated 'Improvement Taskforce', which will include nominated staff from theatre departments and be overseen by the Trust Board. It will examine issues outside of pay, including workforce and vacancy pressures, rota design, communication, management and leadership, staff experience, workplace culture and recruitment and retention.
CQC inspection findings
The announcement comes days after the Care Quality Commission (CQC) published findings of a fresh inspection of surgical services at Salford Royal, which found the service still required improvement. The inspection followed a Section 29A warning issued to NCA in October 2025. Inspectors said improvements seen during their latest visit meant the service is considered to be complying with the notice.
The CQC identified 12 breaches of legal regulations, including regarding safe care and treatment, governance and staffing. Inspectors found 501 operations had been cancelled for non-clinical reasons on the day of surgery between September 2025 and May 2026. There were also more than 700 instances where staff had been redeployed between areas to cover shortages between the 2025 and 2026 inspections. Some staff remained reluctant to raise concerns because they feared they would be "dismissed or lead to punitive actions". However, inspectors also found improvements, including in staff workloads and morale among nursing and support staff, while the service's rating for its care improved from 'requires improvement' to 'good'.
Leadership and response
The Trust has also faced scrutiny after its own board papers revealed dozens of patients died or "came to harm" due to treatment delays and serious errors made by staff working under extreme pressure. Kevin McGee took over as interim chief executive of the NCA on Thursday, October 1, following the departure of Dr Owen Williams. He will remain at the Trust for at least six months while a permanent replacement is sought.
McGee said: "We have listened to our Theatre colleagues and understand the significant pressures they have been facing. This offer recognises the extraordinary contribution staff are making through additional voluntary shifts, while also committing to the wider changes needed to improve staffing, working arrangements and the working environment. We believe this is a strong, fair and competitive offer that is our best position and provides a platform for lasting improvements for both staff and patients. Over the coming weeks and months, the Trust will continue to work directly with Theatre staff to secure a long-term agreement and deliver a permanent resolution to the issues that have been raised."
The Trust said it was committed to working with theatre staff to ensure the changes were "fully embedded" and delivered long-term benefits for both staff and patients.
