Hundreds of NHS workers in England and Northern Ireland are taking part in a strike after a pay review panel refused to introduce a 1% pay rise.

Nurses, paramedics and midwives are taking part in the four-hour strike, which started at 7am in England 8am in Northern Ireland. Members of nine unions are participating in the strike.

Unions have confirmed that the action will not impact urgent care services, but some non-urgent operations and outpatient appointments may have been delayed or postponed.

Representatives from the NHS claim that around 12,500 workers are absent today. This represents 1 in 35 members of staff.

A spokesman for the Department of Health said that there was not enough money available to implement the pay rise without impacting frontline services.

General secretary of Unison, Dave Prentis, explained that unlike other strikes, most people using NHS services today will not have noticed much difference. The aim of this strike is to spread the message that health workers should be entitled to this 1% pay rise, rather than to disrupt services or put people’s lives at risk. A review suggested a 1% pay rise in line with the government’s stance on public sector workers. However, this has been turned down, which is why people are angry and upset. Most haven’t had a pay rise in four years and they believe that the work they do warrants this.

The four-hour strike today will be followed by a period of ‘work-to-rule’ measures, which include refusing to do overtime and claiming for extra hours of work. The first NHS strike in more than 30 years was held in October.