The week-long strike is the latest in a series of action
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A week-long strike by domestic staff at a Tyneside hospital has started after late-night talks failed to resolve a row over pay and job descriptions.
The action, by staff working for South Tyneside NHS Foundation Trust, is the latest in a series of walk-outs.
Unions said the role of domestic staff was not being recognised.
Managers will take on the duties of striking workers and sought to reassure patients that standards of cleanliness would be maintained.
They said there would be no disruption to clinical services.
Senior managers
The strike has gone ahead despite talks between unions and management which went on into the early hours of Wednesday.
Steve Gibbons, from the GMB union, said: "Management aren't recognising the role that domestics play and the domestics are now frustrated that we can't agree a job description.
"It is difficult when management have put other worker groups, which are mainly men, and given them a generic job description but are refusing to do so for low-paid women."
He said he was concerned standards of cleanliness would not be maintained during the strike and said the union was available for talks.
The trust said it was disappointed the strike was going ahead despite the offer of a 12.9% increase to the hourly pay rate, rising to 19.2% next year.
Trust director of nursing Dave Shilton said the public had nothing to fear.
He said: "We don't have any of the traditional domestic staff on duty but we have a rota of very experienced senior managers and senior nurses who are doing all of the same cleaning duties that otherwise would have been performed by the domestic staff."