On the eve of the latest strike, health chiefs have issued a stark warning that further action could push the system 'beyond tipping point'.
Significant disruption to health and social care services are expected in local hospitals and the community as two strikes are imminent - Wednesday 8 January and Friday 10 January by the Royal College of Nursing. Unison will also be taking strike action on 10 January.
A joint statement from the Chief Executives of the Health and Social Care Trusts in NI said: "The industrial action before Christmas was very effective in highlighting reasonable concerns around fair pay and the impact of long-term staff shortages on the delivery of care.
"We recognise that staff have not taken industrial action lightly and have worked closely with Trusts to ensure that the most essential services have been maintained. However, given the current circumstances, it is difficult to see how further strike action this week can advance their cause.
"There are very strong grounds for believing that the planned strikes on the 8 and 10 January will have much more serious consequences than 18 December.
"Our health and care service is already under considerable strain with severe winter pressures over the Christmas and New Year period. These pressures continue to build and are particularly intense today.
"To put that in perspective, at 2pm on Friday 3 January there were 136 patients waiting over 12 hours in emergency departments to be either admitted to a hospital bed or discharged - and 401 over the previous 24 hour period.
"As of 10:15am today, 7 January there were 217 patients in the emergency departments of Northern Ireland’s acute hospitals waiting over 12 hours and 456 over the last 24 hour period.
"With two strike days planned in the space of 72 hours this week, there are serious concerns that the system could be pushed beyond the tipping point. This could mean that patient safety will be compromised as never before.
"Whilst we continue to support our staff and are respectful of their right to take action, we would urge a postponement. Given the pressurised context, we believe this would be a responsible action as we know their members care deeply about patient and client safety.
"We are all agreed that political leadership, budgetary certainty and investment are the vital components to resolving our many problems.
"None of us in the health and care service can provide these components. While we wait for those who can, our absolute focus must be on looking after patients and clients."
Meanwhile a statement from the Health and Social Care Board said: “Patient and service user safety is of the utmost importance. Regrettably to help mitigate the impact of the widespread disruption across all Trust areas, numerous appointments and treatments have been cancelled and a number of services across our hospitals and the community care sector have had to be stood down or reduced.
A spokesperson for Health and Social Care (HSC) organisations said: “We sincerely apologise in advance for the distress this action will cause to everyone impacted especially our patients, service users and family members.
“Patients and service users impacted by cancellations of appointments and service closures will be notified by their local HSC Trust and appointments will be rescheduled as soon as practicably possible. If patients or service users have not been contacted by their Trust then they should attend their appointment/service as normal.
“All Emergency Departments (EDs) will remain open as normal, however, as highlighted last week, EDs remain under extreme pressure as a result of winter demand. Therefore, reduced staffing levels on 8th and 10th will significantly impact on the ability of the system to discharge patients and further compound pressures in ED and throughout hospital and community services.
“In addition, the South Tyrone Hospital Minor Injury Unit (MIU), Mid Ulster MIU, Bangor MIU will be closed on Wednesday 8th January.
“The priority will be on the treating of emergency and life threatening conditions first. Patients with less urgent conditions may have to wait for lengthy periods.
“We would ask the public to assist us in using services appropriately. Our clear message is if you are seriously ill or injured, then the Emergency Department is the place to go.
“But if you do not need emergency care, we would urge you to please choose alternative services. These include using the online A-Z symptom checker (click here), seeking advice from your local pharmacist, contacting your GP, or the GP Out of Hours services (if your medical condition can’t wait until your GP surgery reopens).
“All Health and Social Care organisations will continue to work alongside the Unions to safeguard urgent and time critical care and to mitigate the effects of the disruption.
“This is a very stressful time for everyone involved in the delivery of services and we would ask anyone who is availing of HSC services to respect our staff who will be providing services during what will be an extremely challenging week for all.”
For further high level details on the impact of the strike action and action short of strike go to www.hscboard.hscni.net/hsc-industrial-action-updates
The public can find out the waiting times at all EDs and Minor Injury Units across the region by logging onto www.nidirect.gov.uk/emergency-department-waiting-times. This NI Direct webpage is updated hourly.