Health workers waving placards will be picketing hospitals tomorrow, in the first strike the region's Health Service has seen for 12 years.

More than 130 medical secretaries on Wearside have started a three day strike for more pay.

It is believed to be the first strike action by NHS staff in the region since 1990 - and there are fears that it could spread to other North-East hospitals.

Hospital bosses at the City Hospitals Sunderland Trust say it will be "business as usual" for patients today.

But Unison, the health service union which is behind the industrial action, has warned that some disruption to patient services is almost inevitable.

Talks to avert strike action were taking place yesterday and both sides believe it is not too late to settle the dispute.

The trust has asked Acas (The Advisory, Conciliation and Arbitration Service) to intervene in a bid to resolve the dispute.

Strike action at Northumbria Health Care Trust, which includes North Tyneside General Hospital, has been suspended after management made a new offer to secretaries.

Nationally Unison is pressing for all medical secretaries to be regraded from grade three, which starts at £11,037 and rises to £12,815 to grade four which starts at £12,815 and goes up to £15,546.

The union argues that medical secretaries play a vital role in ensuring hospital clinics and operating schedules run smoothly. Liz Twist, regional offer for Unison, said: "For a long time we have been pushing the cause of medical secretaries. The work they do is increasing all the time.

"We have tried to do this through negotiation but unfortunately we have not been able to negotiate a satisfactory settlement."

Secretaries are due to picket Sunderland Royal Hospital and Sunderland Eye Infirmary today.

The secretaries will hand out leaflets to colleagues and passers-by asking them to support their claim.

"Support is absolutely rock solid for the industrial action. The picket is really just to show that they are prepared to stand up for what they believe," said Ms Twist.

A spokesman for the City Hospitals Sunderland Trust said: "We would wish to reassure all patients and users of our services that regardless of action it will be business as usual and that outpatient appointments, inpatient and day case surgery and all other services, will operate as normal."