Scores of nurses in Norfolk and Waveney have taken to picket lines amid a rumbling dispute over pay and work conditions.
For the first time in decades, members of the Royal College of Nursing (RCN) in the region staged walkouts in an effort to secure an inflation-busting pay rise.
The demonstrations were part of the second round of winter strikes organised by the RCN - but the first to be held locally..
While union members in certain Norfolk and Waveney health trusts did vote in favour of industrial action last year, demonstrations held in December did not include the region.
But on Wednesday, local nurses armed with banners and signs gathered to make their voices heard, including outside of Norfolk's largest hospital.
At the Norfolk and Norwich University Hospital in Colney there was a strong turnout as nurses took part in the walkout.
Picketers were met with tooting horns from passers-by, with a standout banner delivering a defiant message to critics of the decision to strike.
"People are not dying because nurses are striking, nurses are striking because people are dying," it read.
There were also demonstrations held outside of Hellesdon Hospital, the headquarters of the Norfolk and Suffolk NHS Foundation Trust - the region's mental health trust.
The organisations that voted to join the picket lines were:
- NHS Norfolk and Waveney integrated care board
- Norfolk and Norwich University Hospital
- Norfolk Community Health Care Trust
- Norfolk and Suffolk NHS Foundation Trust
The strikes led to some disruption in health services, with a number of appointments cancelled due to staff shortages.
However, the full extent of the impact are not set to be revealed until later this week.
Health bosses have reassured any people with postponed appointments they will be rescheduled as a priority - rather than going to the back of waiting lists.
A spokesman for the Norfolk and Waveney integrated care system said: "While pay is a matter for government and the trade unions, Norfolk and Waveney Integrated Care System value our staff and want to see a resolution as soon as possible to ensure we can continue to focus on delivering patient care to all those who need it."
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here