NHS staff staged a strike as part of their fight for better pay.

Nurses, midwives and ambulance workers walked out today for four hours following a row over whether they should receive a one per cent pay rise.

Two picket lines were set up outside the Royal Bolton Hospital, run by Bolton NHS Foundation Trust, as more than 100 staff took part in the strike from 7am.

They were joined by members of community health centres and district nurses who also took part in the action.

Karen Reissmann, a Unison representative for the Greater Manchester West Mental Health Foundation Trust, which runs wards at the Royal Bolton, said staff have had to put up with years of pay freezes and increasing stress.

She said: “Staff have got to the point where they are doing two people’s jobs, working long hours and not able to take breaks.

“At the same time when MPs have elected to give themselves a 10 per cent pay rise, it’s outrageous.

“We have got to stand up and fight this, to stand up and fight not only our members but also our health service.”

The strike comes after NHS staff walked out for the first time in 32 years last month.

Unions are unhappy that the Department for Health has refused to implement the recommendations of an independent pay review body, that said NHS workers should receive a one per cent pay rise.

Jeremy Hunt, Secretary of State for Health, said the government could not afford the pay rise without risking frontline jobs.

Heather Edwards, head of communications at the Royal Bolton Hospital, said more estates and administrative staff walked out then previously.

She added: “Overall there was little impact for patients as our contingency plans – for instance in postponing some clinics – came into effect. No emergency or very urgent care was affected as agreed with the unions. “

A spokesman for the North West Ambulance Service said there were no ‘adverse incidents’ during the four-hour strike, but acknowledged some patients would have had to wait longer for a paramedic.

Altogether the organisation was operating with 72 per cent of its usual front-line resources during the industrial action.

Director of Operations, Derek Cartwright, said the service coped very well during the strike.

He said: “There was no doubt that today would be a challenge but one I believe we have managed extremely well.

“Every life-threatening call received by the Trust was responded to and I am very grateful for the staff and who assisted those who urgently needed help.

“I’d also like to thank the public for heeding our messages to only call 999 in real emergencies.

“The number of calls received was greatly reduced from the same time last week which helped us to focus our resources on those with life-threatening or potentially life-threatening conditions.”