Health services across the country will experience major disruption again this morning, as 37,000 nurses and midwives take to the picket line.

A government offer of talks has been roundly rejected by their union, the INMO, as the discussions wouldn't address their pay claims.

37,000 INMO nurses will walk off the job and onto the picket line for a second day from 8am over their dispute with the government on pay and staff shortages.

A suggestion by Ministers Simon Harris and Paschal Donohue for talks on issues other than pay has been dismissed as "spin masquerading as substance" by the INMO. 

Up to 50,000 people will be affected by the action.

All outpatient appointments, surgeries and routine community nursing activities are cancelled.

Local injury units, and nurse-led day centres for older people and those with disabilities are closed.

The advice is to stay away from emergency departments. 

The HSE's mental health services face disruption too, as the Psychiatric Nurses Association are extending an overtime ban tomorrow and Thursday in their own row over pay and working conditions.

With unions and government entrenched in their views, it seems a breakthrough is a long way off.

The Saolta University Health Care Group says today’s industrial action planned by the Irish Nurses and Midwives Organisation will have a significant impact on patient services across all of their hospitals.

The Saolta Group comprises of hospitals in this region including Mayo University Hospital.

The industrial action is planned to take place at all public hospitals, healthcare facilities and community healthcare services from this morning 8am tomorrow morning.

The Saolta Group say they are continuing to work with the INMO on arrangements for the day to ensure safe service provision; however scheduled services are cancelled.

All Out Patient, Inpatient and Day Surgery appointments are cancelled and Roscommon University Hospital Injury Unit is also closed today.

If a patient’s procedure is going ahead, the relevant hospital will be in contact directly with the patient to let them know.