The dispute between NHS staff and the government continues to dominate headlines, nearly 4 months on from the first wave of strikes.

Progress has been made and agreements have been reached with some unions, but many healthcare professionals are still no closer to securing what they’re asking for. The spotlight has been on nurses and junior doctors more recently. Members of the Royal College of Nursing (RCN) union rejected an offer from the government and plan on resuming strike action over the May bank holiday.

The situation hangs in the balance. Impacts are being felt across wider society with an enormous knock-on effect on public health and care systems around the country.

Who’s still striking?

The government’s offer of a 5% pay increase from April and a one-off bonus applied to all NHS England staff apart from doctors.

This has been rejected most noticeably by the RCN union which represents nurses and Unite which represents some ambulance workers across the country. Both are asking for improved offers to be tabled as soon as possible.

Junior doctors have been bolder in their terms. They’re asking for a 35% pay rise to account for a 26% real wage loss with inflation since 2008. The government has clearly stated that an increase of this magnitude is simply unrealistic given the current economic climate.

What does this mean for patients?

Strike action has had significant consequences for both primary and secondary healthcare. NHS England figures show that nearly 200,000 appointments and procedures were cancelled during the last round of strikes by junior doctors.

This only further delays and disrupts patient care that was already pushed back from strike action in the past few months. Consequences for public health haven’t fully been evaluated, but it’s likely to be significant.

Not only do cancelled appointments delay patient treatment, it’s fair to say that the quality of care may be impacted by distractions in and around healthcare settings. This may leave the NHS liable to more medical negligence claims if standards aren’t met consistently.

Could there be a stalemate?

The unions continuing to strike are adamant in their pursuit of what they deem a fair pay rise. Junior doctors are unlikely to get their 35% increase, but it’s up to the government to offer a deal worth accepting. Otherwise, junior doctors could be striking for many more months to come.

The RCN appears to be a little less demanding, but the government clearly needs to do better than 5% in both cases and the ball is in their court to make progress here.