Health workers and paramedics took to picket lines outside the Countess of Chester Hospital and the city’s ambulance station for a second four-hour strike over pay.

Unison, Unite, GMB. the Royal College of Midwives and the Society of Radiographers were among unions striking across England, with an impact on the Countess and North West Ambulance Service although emergency cover was maintained.

Staff, who withdrew their labour between 7am and 11am today (Monday, November 24), are angry after the government rejected the independent Pay Review Body’s recommendation of a 1% pay rise for 2014/15. A total of 11 unions took part compared with seven during last month’s four-hour strike.

The strike will be followed by six days of action short of a strike between Tuesday and Sunday when members will take their scheduled breaks, leave on time and not work unpaid overtime.

Radiographer Anne Kember, a union representative at the Countess, said: “The government didn’t take any notice of our independent review body, they did for the one that looks after MPs’ pay and they took their 11%. Our independent review body recommended just 1% but they say they can’t accept that one. In Scotland and Wales it has been accepted. In England they won’t even talk about it.

“It’s not asking for a huge amount – 1% pay rise. At the same time they expect people in the health service to work even longer. We are busier than ever.”

Porter Dennis Robinson, branch secretary of Unite, said: “It’s just asking for a fair day’s pay for a day’s work. We have lost a hell of a lot of pay because of the pay freeze. The cost of living is going up but the wages are not going up. At the end of the day it’s ridiculous.”

Gill Galt,, a spokeswoman for the Countess of Chester Hospital NHS Foundation Trust, said: “The Trust has been working with its union representatives to keep disruption to a minimum and ensure the quality of patient care has not been compromised as a result of today’s industrial action.

“Emergency services, urgent care, maternity labour suite, trauma operations as well as most outpatient clinics have all been running. There was a planned reduction in community midwife services, fracture clinics, radiography and changes to scheduling for planned and routine operations up to 11am, which were all rearranged in advance of today.”

“The biggest issue and concern for the Trust is that we will see an increase of activity and pressures within our accident & emergency department later this afternoon, after the strike has finished and more ambulances start arriving at the hospital. We would ask for the public to be mindful that A&E may be extremely busy, and to think carefully about whether they may be able to get the support they need from their GP, their pharmacist or NHS 111.”