Image copyright Pacemaker

Northern Ireland's nurses have begun another 48 hours of industrial action as they press for pay parity with colleagues in the rest of the UK and for improved staffing levels.

They are refusing to do things like working overtime shifts, working unpaid hours and answering phones on wards.

The Belfast Health Trust cancelled hundreds of outpatient appointments on Monday as workers' action continued.

The trust said all appointments scheduled on Tuesday should go ahead.

However, some day centres will be closed - the trust said it had contacted anyone affected by the closures.

The latest information on disruptions and cancellations is available on the Health and Social Care website.

Image copyright Pacemaker Image caption The action on Tuesday comes after nurses at the Royal Victoria Hospital took industrial action last week

Meanwhile, it has emerged that paramedics will join strike action for 24 hours from 07:00 GMT on 18 December.

Members of Unison - NI's largest health workers' union - within the Northern Ireland Ambulance Service will take targeted action to cause service disruption.

The action will include frontline crews, non-emergency staff, control and support staff, but it is understood that emergency cover will be maintained to "protect life and limb".

In a statement, NIAS said it was "not yet possible to quantify the impact on the service" although there may be a delayed response to some calls".

The Department of Health has said it was disappointed that unions last week turned down a pay offer involving an extra £28m a year.

System 'at point of collapse'

Tuesday's industrial action by Royal College of Nursing (RCN) members comes a week after a 24-hour protest in which they refused to do any work that was not directly related to patient care.

The RCN said it has about 16,000 members in Northern Ireland, where some 17,000 nurses and 5,000 nursing support workers are employed in total.

Image caption Nurses in the Unison union were on the picket line at Altnagelvin Hospital in Londonderry on Monday

In November, nurses voted to take part in strike action for the first time in the 103-year history of the RCN union.

Health workers have said they are unhappy about pay and claim staffing levels are "unsafe".

The Royal College of Surgeons warned last month that Northern Ireland's healthcare system was "at the point of collapse".

Unions rejected a new pay offer by the Department of Health last week because it did not reach parity with staff in England.

On Monday, it was announced that Unison nurses at Londonderry's Altnagelvin Hospital had joined the industrial action.

The Belfast Health Trust said all hospital surgeries, inpatient and outpatient appointments on Tuesday and Wednesday would take place as planned apart from outpatient appointments at the School of Dentistry.

The following day centres will be closed on Tuesday from 09:00 GMT until 13:00:

Knockbracken Day Centre

Carlisle Day Centre

Orchardville

Everton Day Centre

Edgcumbe Resource Centre

Suffolk Day Centre

Fallswater Day Centre

Mount Oriel (learning disability service users only)

Ravenhill Day Centre

Everton Day Centre

Whiterock Day Centre

Community day services in north and west Belfast will also not operate.

The following day centres will be providing a limited service from 09:00 until 13:00.