The work-to-rule by members of Unite includes a ban on non-essential paperwork, email exchanges, attendance at meetings and telephone calls.

The union is taking action nationwide in protest at what it describes as a "derisory" three-year NHS pay deal.

National Officer for Health David Fleming promised patients would be a priority.

"The welfare of clients and patients will be paramount and emergency cover maintained," he said.

"Our members are struggling to keep up with the cost of living. This is the third year that our members have been forced to survive on below-inflation pay rises.

"If the Government can find billions to rescue irresponsible banks, then it can find money to give hard-working NHS staff a fair rise."

North East regional officer Jeff Tate warned that if the Government failed to make concessions, Unite would scale up industrial action in January.

A national ballot of Unite health sector members voted for industrial action, including walking out.

"Ministers should hear that our members are very angry at the continued below-inflation pay awards, in effect, pay cuts," said Mr Tate.

More than three quarters of Unite members voted in favour of industrial action short of a strike, with just over half voting in favour of a strike.

The union says it is seeking to defend and strengthen the independence of the Pay Review Body (PRB) to decide pay on an annual basis. The PRB recommended a 2.75 per cent pay award for the year 2008/9 but the Government imposed the three-year deal worth in total 7.99 per cent.

Unite's list of demands includes:

• addressing the pay issue which has seen below inflation pay rises for NHS staff for the last two years;


• an understanding that the independence of the Pay Review Body (PRB) will not be "abused" in future;


• a full-scale review of the Government's public sector pay strategy.