Rishi Sunak is under increasing pressure to personally intervene to avert a major escalation in strike action by tens of thousands of NHS workers in England and Wales over the coming weeks. A Tory former cabinet minister was among those to call for the prime minister to negotiate with unions planning action over real-terms pay cuts caused by soaring inflation. On Friday, Unison announced that a further 12,000 ambulance workers would be able to join 35,000 of their colleagues and tens of thousands more nurses in walk outs. A ballot of 50,000 junior doctors is expected to come back in favour of strike action next week. And 35,000 consultants have been asked to take part in an indicative ballot on whether they could take strike action in future. The former cabinet minister described it as outrageous that the prime minister was “so focused on hiding in plain sight”. “There are many ways he [Sunak] can ensure nurses get an attractive pay offer that will leave them feeling encouraged to stop the strikes that ultimately leave people in danger, but it seems to be beyond him”. They added that Boris Johnson would have finalised a creative pay offer for nurses by now, a sentiment a number of Tory MPs agreed with. “It’s time the prime minister ditched his do-nothing strategy for dealing with escalating strikes across the NHS,” said the general secretary of Unison, Christina McAnea. She claimed that authorities in Scotland and Wales were showing more willingness to negotiate than Westminster. “Sadly, health workers across England have been met with a wall of silence from No 10. The prime minister stubbornly refuses to talk about pay, preferring to subject everyone to many months of disruption. “The public must think the Westminster government is living on another planet. The prime minister must roll up his sleeves, invite the unions into Downing Street and start the genuine pay talks that could end this damaging dispute.” Tens of thousands of nurses will walk out of 120 hospitals for 48 hours next month. For the first time, the strikers will include those working in cancer wards, emergency departments and intensive care units – marking a significant escalation in the dispute. Both Unison and the Royal College of Nursing (RCN) said the ball was now in the prime minister’s court. Pat Cullen, the general secretary of the RCN, said: “We are working night and day with NHS leaders, but we can also see NHS leaders stepping in and writing to the prime minister. “There is no doubt there will be a significant impact [from the strikes] and we are now urging the prime minister to step in with 12 days left, to try and resolve this, around a round table today,” she told BBC Breakfast. The college is calling for pay rises of 5% above inflation to not only raise its members’ living standards, but to “turn the tide on years of unfilled nursing jobs”. It has accused the government of refusing to engage in negotiations, with Cullen saying there has been “no communication” from the health and social care secretary, Steve Barclay, for more than a month. Asked on BBC Radio 4’s Today programme if she accepted the strike action would pose a significant risk to patients, Cullen said: “What I accept is that there will be significant changes in the 48 hours. And of course there will continue to be extreme challenges.” Asked again, she said: “What our patients are facing every day, in a depleted health service, a health service in crisis, poses significant risk and significant challenge.” The prime minister has been urged to step in to avert the threat of fresh strike action by nurses and ambulance workers that is likely to have a “significant impact” on NHS services in England. A Department of Health and Social Care source said: “The health and social care secretary has been engaged in a reasonable dialogue with unions to try to find a responsible and fair solution and has held more than a dozen meetings with union representatives since taking on his role. “He wants to continue discussions with unions about what is reasonable and affordable in the coming year’s pay review body process as that is the best way for resolving the dispute. Unaffordable pay rises will only fuel inflation.” Unison said the result of a re-ballot of 12,000 workers – mainly in workplaces where the legal threshold for a mandate to strike was narrowly missed last time round – meant they would join 20,000 other colleagues on strike, in what the union said was a “significant escalation” of the dispute with government. It said the ambulance strikes would now cover most of England and include workers in Wales. Two other unions, GMB and Unite, also represent a combined total of more than 15,000 ambulance workers – all of whom have a mandate for strikes. The chief executive of the NHS Confederation also urged Sunak to settle the matter to reduce waiting lists. Matthew Taylor told BBC Breakfast: “That really difficult challenge of reducing waiting lists becomes almost impossible if this industrial action spreads, as it is spreading, and particularly if junior doctors join the industrial action. “So the government’s aspiration to lower waiting lists, its public commitment to lower waiting lists, is now being jeopardised by this ongoing industrial action.” Sir Julian Hartley, the chief executive of NHS Providers, said the fresh strike action was “very worrying in terms of the potential impact”, but he urged patients to still attend appointments unless they were cancelled. He told Sky News: “Although the RCN have said they plan to work at a national level to make sure that there is life-preserving care, trust leaders I know are extremely concerned and worried about the potential impact for patients on this next round of action.” The British Medical Association has balloted junior doctors on strike action, with a result expected early next week and, should they back a strike, industrial action is likely to follow within weeks. It is also holding an indicative ballot in respect of consultants and the BMA said on Friday it would determine its next steps based on the result of that exercise.