Paying nurses a “decent wage” is the only way to prevent them leaving the NHS and to fill thousands of vacancies, the head of the Royal College of Nursing (RCN) has said as the union ballots on strike action.

For the first time in its 106-year history, the RCN is asking all of its UK members if they are prepared to walk out over pay.

General secretary Pat Cullen said nurses will still provide critical care if the strike goes ahead, as the RCN asks for a pay rise which exceeds inflation by 5%.

But Prime Minister Liz Truss refused to budge when pressed on the issue, telling broadcasters during a visit to Prague: “I just want to thank nurses for the fantastic job they do.

“They worked incredibly hard during Covid.

“We now face a huge backlog after the Covid crisis.

“They do a great job.

“What we have offered nurses is a £1,400 pay rise.

“That was recommended by the pay review body.

“So I do hope that they will continue to work through this winter, but I do want to say a great thank you to our nurses for the brilliant job they do.”

Ms Cullen earlier told BBC Radio 4’s Today programme: “Nurses will do nothing to add to the risk that patients are facing every single day as a consequence of not having those nurses in the system to look after them.

“We continue to provide critical services throughout any strike.”

The only way that we’re going to address those vacancies and ensure that we recruit nurses into our health services and hold on to the brilliant services that we’ve got is if we pay them a decent wage

She said nurses are taking action to “save the health service”, adding they are currently “struggling to provide safe care for their patients” due to a lack of staff.

“Nurses have made every attempt to get Government to listen to the fact that there’s hundreds of thousands of nursing vacancies across this country and nurses are struggling to provide safe care for their patients,” she said.

“The only way that we’re going to address those vacancies and ensure that we recruit nurses into our health services and hold on to the brilliant services that we’ve got is if we pay them a decent wage.

“We’re very clear. Our position is that in order to address the crisis within the profession, it’s (pay of) 5% above the rate of inflation.

“If this Government does not address that, then our fear is that we’ll continue to lose the great nurses we’ve got.

“We’re losing thousands of nurses from our health service and that’s against a backdrop of thousands and thousands of vacancies.”

She added that the Government’s offer of a 3% wage rise “makes a difference to a nurse’s wage of 72p a week”.

She added: “I don’t think that’s the decent thing to do for nursing staff or the decent thing to do for patients.”

Nurses will start voting on Thursday on whether to strike over pay, with 300,000 members asked to take part in the ballot.

The RCN said new analysis by London Economics to coincide with the ballot launch shows pay for nurses has declined at twice the rate of the private sector in the last decade.

Nurses’ real-terms earnings have fallen by 6% compared with 3.2% for private sector employees, it was found.

The ballot closes on November 2.

Labour leader Sir Keir Starmer repeatedly said he does not want strikes to go ahead, though he added he understands why nurses are considering them.

On whether he would back them, he told BBC Radio Devon: “I completely understand why people are concerned and considering industrial action.

“But let me be clear… I don’t want these strikes to go ahead.

“The last thing that anybody who works in the NHS wants is to go on strike, what they need is a resolution of the issues.”

Pressed again on whether he would offer nurses his support should they choose to strike, he said: “I understand why they are wanting to take action. I don’t want the strikes to go ahead.

“I don’t think they want strikes to go ahead. Of course they don’t.”

The RCN is inviting members of the public to co-sign a letter to Prime Minister Liz Truss which says: “On behalf of the nursing profession, I implore you to see sense.

“Protect nursing to protect the public.”

The union said new polling carried out by YouGov showed support from two-thirds of the public for nurses taking strike action, while three-quarters of respondents said there are too few nurses to provide safe care in the NHS.

The trade union Unison is already balloting more than 50,000 health workers on strike action, while the Royal College of Midwives in Scotland opened its ballot last month.

Scottish Health Secretary Humza Yousaf has promised NHS staff he will make a “significantly improved” offer after the record 5% pay rise put forward by his Government was rejected.

In 2019 and 2020, thousands of nurses in Northern Ireland walked out over pay and staffing.

The Health and Social Care Board said 4,749 hospital appointments were cancelled as a result of the 2019 action.