Nurses in England, Wales and Northern Ireland have begun the first of two day-long strikes over pay - a walkout will also take place on 20 December.

Staff will provide 'life preserving' and some urgent care, but routine services are likely to be disrupted in the biggest ever walkout by NHS nurses.

Up to 100,000 members of the Royal College of Nursing (RCN) in England, Wales and Northern Ireland are holding a one-day stoppage from 0800 to 2000 GMT after rejecting a government pay offer.

Ameera, a senior nurse in London, told AFP that “we have not chosen industrial action lightly”. The strike is the first in the Royal College of Nursing union’s 106-year history.

“We’re tired. We’re fed up,” added the nurse, who asked that her last name not be reported. “We need a pay rise now to make a living.”

The head of the Royal College of Nursing, Pat Cullen, says: "this is a tragic day for nursing, it’s a tragic day for patients"

The Royal College of Nursing (RCN) wants a 19% pay rise and says below inflation increases are compromising care by making it hard to attract and retain nurses.

The government says the RCN's demand is unaffordable and that it has met independent recommendations on pay.

Chemotherapy and kidney dialysis should run as normal, along with intensive and critical care, children's accident and emergency and hospital neonatal units.

The biggest impact is likely to be in pre-booked treatment such as hernia repair, hip replacements or outpatient clinics. (ased on reports by BBC and AFP)