New strike action announced by the Royal College of Nursing (RCN) is to be the most far-reaching yet and include critical care provision.

In its announcement yesterday, the RCN said the strikes at 128 NHS employers in England on 1-3 March would have “no wide-ranging derogations” in place.

The union commented: “Services previously ‘derogated’ will not be to the same extent. We are working directly to ensure that these services are reduced to an absolute minimum. It is always the employer’s responsibility to ensure life-preserving services, so we expect life-preserving care to be provided by members of the wider workforce and other clinical professions.”

Trade union law commits members to providing life-and-limb cover but employers will be asked to negotiate with union leaders to ensure this is carried out.

The RCN has said it will only provide cover in the event that services are unable to use non-unionised nurses.

Legislation is currently making its way through Parliament that would force unions to provide minimum levels of care during strike action.

RCN general secretary & chief executive Pat Cullen said: “I will do whatever I can to ensure patient safety is protected. At first, we asked thousands to keep working during the strikes but it’s clear that is only prolonging the dispute. This action must not be in vain – the prime minister owes them an answer.”

Sir Julian Hartley, chief executive at NHS Providers, said continuous 48-hour strike action with no exceptions in A&E, intensive care units or cancer care services would be a “huge blow”.

He said: “With further strikes by ambulance workers planned in the coming days and weeks, and junior doctors’ walkouts also likely, trust leaders are now in a near-impossible position. They’re deeply concerned the escalation could hamper their efforts to tackle care backlogs and compromise continuity of care for some.”

Health and social care secretary Steve Barclay said: “Failure to provide cover during strike action for key services like cancer care is a significant escalation from the Royal College of Nursing that will risk patient safety.

“We are working closely with NHS England on contingency plans, but this action will inevitably cause further disruption for patients.

“I’ve had a series of discussions with unions, including the RCN, about what is fair and affordable for the coming year, as well as wider concerns around conditions and workload.”

In Scotland, meanwhile, the RCN said today it was considering a new NHS pay offer from the government.