Nursing unions will meet health service management tomorrow morning in a further bid to avert strike action over pay and staff shortages.

Both the Irish Nurses and Midwives Organisation and the Psychiatric Nurses Association overwhelmingly rejected proposals from the Public Service Pay Commission aimed at addressing recruitment and retention issues in the profession.

The PSPC had rejected the nurses' argument for a 12% across the board pay rise, opting instead for a €20m package of allowances targeted at the sectors experiencing the worst staff shortages.

On Monday, the INMO is due to commence balloting its 37,000 members for 24-hour strikes on Monday, while the PNA will decide by Thursday whether to follow suit.

Following a meeting between the two sides last Friday, the Irish Nurses and Midwives Organisation wrote to the management side urging them to address outstanding agreements on staffing that have not yet been fully implemented.

It is understood that that INMO letter referred to the 2017 agreement aimed at addressing shortages of nurses and midwives in Emergency Departments, which provided for an additional 123 posts to be funded to care for patients on trolleys.

Sources said that not only had all 123 funded posts not been filled, but a further 57 are now needed given the escalation in the number of patients on trolleys.

This issue will be discussed at the Workplace Relations Commission on Thursday.

The INMO has also criticised the failure to fully deliver funding for the task force on staffing levels for nurses.

It is understood that in its response delivered yesterday evening, the HSE indicated that such issues would have to be addressed in the context of the organisation's Service Plan which is not yet complete. 

INMO sources voiced disappointment with the HSE's response, saying it failed to provide certainty or commitments around what funding would be delivered for these projects.

The union believes that health service management is in breach of the current Public Service Stability Agreement because of their failure to fully implement the Emergency Department and Task Force on Nursing agreements.

It has given the HSE and the Department of Health until Monday 19 November to deliver what it called "realistic" proposals on pay - or it will commence its ballot for a series of 24-hour strikes. 

Meanwhile, the Psychiatric Nurses Association has called for an immediate "fairly substantial down-payment" of pay for its 5,000 members, coupled with a 3-month review to address outstanding pay issues.

SIPTU, which represents around 4,000 nurses, has accepted the Public Service Pay Commission proposals.