Nurses could keep holding strikes “up until Christmas” if the current dispute is not resolved, the leader of the Royal College of Nursing (RCN) has told Sky News.

Pat Cullen, the head of the RCN union, was speaking as her members picket today – although the period of action is truncated after judges ruled the mandate to withdraw labour expired tonight.

But members will be reballoted after rejecting an offer put to them earlier this year, despite other unions accepting it.

“It is for the secretary of state to come back around the table and put a better offer on the table,” Ms Cullen told Sky News.

If this fails to materialise, Ms Cullen said the country could “see our nursing staff on picket lines up until Christmas. But we don’t want that”.

“We do need to bring this health service back from the brink.”

When it comes to nursing, the GMB and Unison unions voted to accept the government’s pay offer of 5%, plus a lump sum.

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But the RCN and Unite have rejected the same terms.

An NHS staff council meeting will be taking place on Tuesday this week, and if most of the unions and their memberships indicate their support for the pay offer, it will likely be imposed by Health Secretary Steve Barclay.

This offer does not cover the next pay period, however, and disputes over those terms could continue.

With the RCN walking out from around 100 trusts, the health providers have shared how they will struggle to staff wards.

Matthew Taylor, the chief executive of the NHS Confederation, told Sky News: “We will cope with today, but it will be difficult.”

He added: “The critical issue now is that the staff council meets tomorrow, and we hope that that staff council will work together and accept the deal, and we can finally end this industrial action.

“Though, of course, the junior doctors’ action is still ongoing.”

The junior doctor dispute is part of a separate dispute to the nurses and other unions.

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