Rishi Sunak is under growing pressure to negotiate with striking nurses after four former Conservative ministers joined health service leaders to call for a way out of the escalating dispute. On a day in which England’s chief nurse joined the picket line, the prime minister and the health secretary, Steve Barclay, were implored to make a U-turn and ask the NHS pay review body (PRB) to look again at the rise it recommended earlier this year. The idea gathered momentum during the first NHS-wide nurses’ strike, which led to the cancellation of thousands of outpatient appointments and operations across England, Wales and Northern Ireland. Members of the public put on noisy displays of support for nurses on the picket lines on Thursday, backing them in their fight for a pay rise that takes account of the soaring inflation that has eroded living standards. The Royal College of Nursing (RCN) has threatened to stage walkouts for months to come if ministers do not start negotiating a better deal than the £1,400-a-head, which Sunak and Barclay insist is the most they can afford and is in line with the PRB’s findings from February. Jerry Cope, a former head of the PRB, said the body should consider revisiting its original finding that most NHS staff deserved a £1,400 pay uplift for 2022-23, as it “may be a possibility for a solution for this apparently intractable problem”. He said: “I think they [ministers] should ask the pay review body to … do a very quick turnaround for this year’s recommendations and [say]: ‘I want you to take account of anything you might have missed last time round’.” The PRB is a long-established independent body that advises ministers what size of pay awards nurses and the bulk of the UK’s 1.5 million NHS staff, excluding doctors and dentists, should receive. The NHS Confederation, the hospitals body, told ministers on Thursday night a fresh approach was needed to avoid the risk of their dispute with the RCN turning into a protracted “stalemate” that would disrupt key NHS services and patients’ treatment. Steve Brine, a former health minister who now chairs the Commons health select committee, said inviting the pay review body to look again would be sensible. “It seems to me there is no end game, no exit strategy for the government and the RCN in this dispute. The way out is to protect the integrity of the [pay review] process, go back and ask them to look again,” he said. If ministers did seek a re-evaluation, Brine said, the RCN should show good faith by calling off the second strike, which is due to take place on Tuesday 20 December. That would be “the flipside” of ministers abandoning what has been their insistence that they cannot deviate from the PRB’s recommendation, which came before Russia’s invasion of Ukraine triggered runaway inflation. “I think everybody needs to cool it,” Brine said. Robert Buckland, a former justice secretary, said “a middle way” must be found between the 4% offered by the government and the rise of 5% above inflation the RCN has been seeking (currently amounting to 19%, based on RPI of 14%). “I just hope both sides can find it,” he said. The union has made clear in recent days that it would consider lowering the size of the percentage rise it was prepared to accept in order to help reach a deal. Jake Berry, the Tory party chair under Liz Truss, and Dr Daniel Poulter, another former health minister, also made clear their support for a negotiated settlement involving the PRB. Matthew Taylor, the chief executive of the NHS Confederation, blamed ministerial intransigence for Thursday’s strikes, which involved up to 100,000 nurses. “The strikes could have been avoided had the government attempted to find more common ground with the RCN on pay,” Taylor said. “The government cannot just sit back and let future strikes happen when patient care is on the line. “The worry is that this is just the start, that strikes possibly being planned for January could be more severe and coordinated across the different unions, and that we could be in a position of stalemate for the foreseeable future. “This benefits no one and the government must act,” he said. Danny Mortimer, the chief executive of NHS Employers, underlined the prospect of nurses’ strikes having an increasing impact on the NHS. Without ministerial “willingness to negotiate on pay-related matters”, the RCN’s next series of strikes could affect more hospitals, last for longer and see fewer areas of care exempted on patient safety grounds, he said. In an unexpected move, Ruth May, NHS England’s chief nurse, joined the picket line of nurses striking at St Thomas’ hospital in London, across the River Thames from the houses of parliament. She told journalists that ministers should work with the RCN and other health unions to resolve the wide differences between them over pay. Reflecting on the strikes, Pat Cullen, the RCN’s general secretary, said: “Today will be a turning point in the campaign for fair nursing pay. At the end of it, ministers find themselves under fresh pressure from unexpected places – their own MPs, NHS leaders and a former chair of the pay review body. “Each of these groups, for different reasons, wants the government to stop hiding behind its current fig leaf. “On a bitterly cold day, the public warmth towards nursing staff was immense. For my members, this has been about professional pride, not personal hardship – speaking up for nursing, patients and the future of the NHS.” Meanwhile, Sir Jim Mackey, a senior NHS England director, warned that next Wednesday’s strike by ambulance workers across England represented “a completely different order of magnitude of risk [than the nurses’ strike]” to patient safety. All surgery planned for that day may have to be cancelled “as an absolute last resort”, to free up staff to look after patients needing urgent care, he said.