The Royal College of Nursing union is to strike again on the first May Bank holiday after its members rejected the government’s latest pay offer.

What’s surprising about the result is that Pat Cullen, the RCN general secretary, had urged members to vote in favour of the deal, advising them that the new offer they received from the government last month had vindicated their earlier strike action.

Despite her prior recommendation, Cullen was quick to acknowledge the wishes of her members this afternoon, warning Steve Barclay, the health secretary, that unless he came up with a better offer, there would be even more strikes over the next few months. For the first time, the planned 48-hour walkout from April 30 to 2 May means many nurses will not be working in emergency departments, intensive care and other critical care wards such as those with cancer patients.