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Nurses in England have voted to reject the government's offer of a 5.5% pay rise, the Royal College of Nursing (RCN) has said.
Members of the RCN rejected the deal by two-thirds in a record high turnout of around 145,000.
The pay award for 2024-2025 was announced by the chancellor at the end of July, shortly after Labour won the general election.
In a letter to Health Secretary Wes Streeting, RCN general secretary Prof Nicola Ranger said nursing staff were determined to “stand up for themselves, their patients and the NHS”.
The RCN said the high turnout surpassed the level seen in two ballots for industrial action held by the union in 2022 and 2023, the first of which permitted six months of strike action by nursing staff.
The union argues that the pay of an experienced nurse fell by 25% in real terms under the Conservative governments between 2010 and 2024.
Prof Ranger said nurses "do not feel valued", adding they were concerned by "understaffed shifts, poor patient care and nursing careers trapped at the lowest pay grades".
As ministers prepare to set out a new health and social care agenda, Prof Ranger added: "The government will find our continued support for the reforms key to their success."
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