Nurses are “highly likely” to go on strike again after Christmas if the Welsh Government maintains its “silence”, a Royal College of Nursing chief has warned.

Nicky Hughes, associate director of nursing at RCN Wales, claimed health minister Eluned Morgan had refused all calls by the union to enter into negotiations about pay with them up to and during the strike day on Tuesday.

The 12-hour walk out, the second in less than a week, saw around 10,000 NHS nurses across England, Wales and Northern Ireland stay absent from work, with many of them taking to picket lines to express their concern over pay, staffing levels and patient safety.

Ms Hughes said nurses were prepared to “continue the fight” if no deal was reached, but said discussions were still ongoing about what the union’s next steps would be.

“We’ve seen such an impact over the day with lots of our members out on the picket lines and members of the public have been so generous and supportive throughout, I think we’ve got the public behind us and that’s really important,” Ms Hughes said.

“But we’ve had absolute silence from the Welsh Government.

“The health minister last asked us to go to a meeting as a trade union on the 12th and yet again there was nothing on the table in terms of a meaningful pay award.

“We’ve asked them constantly to come back and open negotiations, even calling on the First Minister Mark Drakeford yesterday to come to the table and avert today’s strike, but there was just silence.

“The Welsh Government says it’s because of the Westminster Government, however, in Wales health is a devolved matter and it’s for the Welsh Government to manage and fund appropriately the NHS in Wales.

“Unless they do, we will continue to haemorrhage nurses. As it is, the NHS is on a knife-edge.”

On future strike action Ms Hughes said: “If the silence continues then it is highly likely. However, discussions are being held and none of that has been decided yet.”

Ms Hughes said further talks with health boards would be needed ahead of any further industrial action after RCN Wales received reports that wards were allegedly being staffed with more nurses than agreed.

“Some of our members have been updating us throughout the day and reporting that some wards had more staff than agreed, and indeed, some have had more staff than they would normally have,” Ms Hughes said.

“So that’s an issue that we will be taking up very strongly with our health boards.

“We’ve worked very closely with them throughout to make patients are safe but, at the end of the day, it is our members’ rights to be able to take legal strike action.”

“Nurses have really had to soulsearch about what this is about and whether they should come out on strike, and they are doing this for safe patient care,” she added.

“They know every day they go into work patients are being harmed because they haven’t got the levels of care that they need, and our nurses are highly distressed about it, that’s why they’re taking this sort of unprecedented stand.”

The RCN is calling for nurses to be awarded a 5% plus inflation pay rise. The current rate of inflation in the UK is over 10%.

Outside the Heath hospital in Cardiff, Helen Perriam, mental health nurse of 10 years, said her family lived “paycheck to paycheck” and called for nurses to have a “dignified wage for the responsibilities (they) hold”.

Ms Perriam accused the UK Government of “shafting” nurses and said she believed the decision not to award them a larger pay increase was a political one – a belief that was shared by many present.

A&E nurse and mum-of-two Georgia Sheppard said: “I would lay the blame with the Tory government in Westminster for not giving Wales enough money to be able to pay nurses fairly.

“I would say to them in Westminster, there’s plenty of money there for the things they want it for, and for their friends who they want to give it to, and the rest of us are losing out.”

A Welsh Government spokesperson said: “We believe all public sector workers should be fairly rewarded for the important work they do.

“The strikes will inevitably have a significant impact on NHS services. But we recognise the strength of feeling among staff, which the difficult decision to vote for industrial action reflects.

“While we were unable to avert this week’s industrial action, all partners have agreed to keep talking and continue to work together.”