Hundreds of NHS staff at four Greater Manchester hospitals have voted overwhelmingly to reject an offer aimed at ending a long-running dispute over overtime pay, with Unison accusing the trust of using 'scare tactics' to pressure workers into accepting.
Nearly all (99 per cent) of the 400-plus theatre staff at Salford Royal, Royal Oldham, Rochdale Infirmary and Bury's Fairfield Hospital voted against the latest proposal from Northern Care Alliance (NCA). The union says theatre staff are now planning the next round of strikes.
Trust's 'best offer' rejected
NCA said it put forward a 'strong and fair' offer on October 7, which it said would see theatre staff receive enhanced payments for extra shifts, as well as improvements to staffing, rotas, management and working conditions. Unison, however, called it the first concrete proposal from the trust to end the dispute.
While staff were considering the offer, the union claims they received communications from the trust that appeared to be an attempt to scare them into accepting. In communications seen by the Manchester Evening News, NCA wrote: "This is our best offer. The Trust will not improve it further."
The trust added: "We are concerned about the future sustainability of our services if industrial action continues. Ongoing disruption affects our ability to recover services, reduce waiting times and deliver the standard of care that patients and service users rightly expect."
"Rejecting the offer will mean further disruption. Industrial action has already led to cancelled operations and delays to patient care, and continued action risks further disruption for patients and service users," the communications continued.
Interim CEO responds
Responding to the ballot results, the trust's new interim CEO Kevin McGee said it was "very disappointing" that theatre staff had rejected NCA's "best offer to resolve this dispute".
McGee said: "Patients have already had operations postponed and care delayed. Further industrial action will mean more delays and uncertainty for patients."
"We cannot allow these delays to continue. We must consider other ways to provide care during industrial action, including arranging for some work currently done by the NCA to be carried out elsewhere," he added. "Our door remains open to UNISON to discuss our best offer and work with us to end this dispute."
Strike background
Theatre staff, including nurses, clinical support workers and housekeepers, have already walked out for 17 days over a five-month period. The latest strikes took place on October 26, October 28 and October 30.
The dispute centres on the use of an outside agency called NHS Professionals (NHSP) to manage additional shifts. Unison has previously claimed the arrangements meant some staff could earn less for an additional shift than they previously did, with some workers missing out on as much as £80 a shift.
Under the new package, NCA said eligible theatre staff working additional voluntary shifts during a "period of extraordinary pressure" will receive enhanced NHSP bank rates. But the union adds workers are unlikely to accept any offer involving a third party to handle overtime payments.
Unison North West regional organiser Kevin Dolan said: "Staff are sending a resounding message to NCA bosses. They're standing together and won't be deterred in their fight for what's right."
"It's disappointing the trust has resorted to scare tactics, by telling staff this was the final offer. But that's not the trust's decision to make," Dolan added. "The union is writing to NCA immediately to make clear workers will carry on striking until they get fair pay."
The dispute comes as the trust has 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. Papers published in July showed around 12,000 cases of delayed treatment were recorded last year, with lengthy delays linked to 28 deaths and 56 cases of severe harm, while problems diagnosing illness were linked to ten deaths.
Last month, 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. In its latest report, CQC identified 12 breaches of legal regulations, including regarding safe care and treatment, governance and staffing. Inspectors said the improvements seen during their latest visit meant the service is considered to be complying with the notice.
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'.
