Nursing union leader Pat Cullen has called on Health Secretary Stephen Barclay to restart pay negotiations with a proposed rise in double digits.

Royal College of Nursing (RCN) members will begin a new ballot for strike action on May 23 after the existing six-month mandate ran out at the start of the month.

And the general secretary, who described striking as one of the “hardest decisions”, told The Sunday Times fresh negotiations were needed to prevent six more months of action.

“They (ministers) owe that to nursing staff not to push them to have to do another six months of industrial action right up to Christmas,” she said ahead of Sunday’s RCN congress in Brighton, telling Mr Barclay talks need to “start off in double figures”.

“It’s just not right for the profession,” she said.

“It’s not right for patients. But whose responsibility is it to resolve it? It is this government.”

Having pushed for a 19% pay rise, she had advised members to accept an offer of 5% – a deal they rejected despite being accepted by 14 other unions.

“It’s not so long ago since the Prime Minister went on the media and very publicly said nurses are an exception,” she said when asked why nurses warrant a larger increase than other healthcare workers.

“I would totally agree with him… they should be made an exception because they are exceptional people.”

The mental health nurse, 58, from Co Tyrone, said patient safety was “at the centre of everything that we do”.

“We will do nothing that will add further risk to the patients that we look after,” she said, saying increased pay would see nurses return to the profession and ease a staffing crisis.

“The truth is that patient safety cannot be guaranteed on any day of the week. How could you guarantee patient safety when you have 47,000 nurses from your workforce every single day and night?”

She warned Prime Minister Rishi Sunak not to take her members lightly.

“Looking back on this pay offer, I may personally have underestimated the members and their sheer determination,” she said.

“I think what I would be saying to the Prime Minister, Rishi Sunak, is ‘Don’t – don’t make that same mistake, don’t underestimate them’.

“Nurses believe it’s their duty and their responsibility because this government is not listening to them on how to bring it (the NHS) back from the brink and the message to the Prime Minister is that they are absolutely not going to blink first in these negotiations.”