There is no-one “at any level” in the Government who is involved in talks about NHS pay as the health service faces what is expected to be the biggest strike in its history, a union leader has said.

Tens of thousands of nurses and ambulance staff in England are set to walk out on Monday, with nurses due to strike again on Tuesday and ambulance crews and call handlers returning to the picket lines on Friday.

Unite general secretary Sharon Graham was asked on the BBC’s Sunday With Laura Kuenssberg programme whether “on the eve of the biggest health strike in history there is zero conversation between anyone in your union and anyone at all speaking for the Government?”

Ms Graham replied: “I can categorically say to you we are in no talks at any level whatsoever with the Government about pay in the NHS, and that is a real abdication of responsibility.

“Why is Rishi Sunak not coming to the table? Instead of doing sort of press conferences about other things, come to the table and negotiate – roll your sleeves up and negotiate on the pay in the NHS, that is what’s required.

“I can tell you categorically that there has been no conversations on pay whatsoever with (Prime Minister) Rishi Sunak or (Health Secretary) Steve Barclay about this dispute, in any way shape or form.

“They’ve danced around their handbag, they danced around the edges, but they will not talk about pay.

“To me, that is an abdication of responsibility (as) the dispute is about pay – so how can they say they are in talks?”

Her comments come after nursing leaders issued a direct appeal to Mr Sunak to intervene in their pay dispute.

In a letter to the Prime Minister, Royal College of Nursing (RCN) general secretary Pat Cullen said a “meaningful” pay offer from the Government could still avert strike action.

She drew a comparison with his swift action to sack Conservative Party chairman Nadhim Zahawi after he was found to have breached the ministerial code in relation to his tax affairs.

She wrote: “As shown by last weekend’s fast-paced changes in Cabinet, big decisions can be made by you at any point in the week in the interests of good government.

“I am urging you to use this weekend to reset your Government in the eyes of the public and demonstrate it is on the side of the hardworking, decent taxpayer.

“There could be no simpler way to demonstrate this commitment than bringing the nurse strike to a swift close.”

With negotiations also continuing in Scotland, Ms Cullen warned Mr Sunak that his Government is becoming “increasingly isolated”.

On the walkouts in England on Monday, Ms Cullen added: “It will be the biggest day of industrial action in the 75-year history of the NHS.

“Nursing staff find that a sobering realisation of how far they have been pushed to protect patient care and secure some respect for the nursing profession.”

Health Secretary Steve Barclay said: “I have held constructive talks with the trade unions on pay and affordability and continue to urge them to call off the strikes.

“It is time for the trade unions to look forward and engage in a constructive dialogue about the Pay Review Body Process for the coming year.”

He added: “Despite contingency measures in place, strikes by ambulance and nursing unions this week will inevitably cause further delays for patients who already face longer waits due to the Covid backlogs.

“We prioritised £250 million of support last month for extra capacity in urgent and emergency care, but strikes this week will only increase the disruption faced by patients.

“The Governor of the Bank of England warned if we try to beat inflation with high pay rises, it will only get worse and people would not be better off.

“It is crucial people continue to access the services they need – please attend your appointments unless told otherwise, use 999 in a life-threatening emergency and use NHS 111 online services, your GP and pharmacy for non-urgent health needs.