Nurses start voting on Tuesday on whether to continue taking strike action in their long-running dispute over pay and staffing.
Almost 300,000 members of the Royal College of Nursing (RCN) in England are being asked to renew their mandate for industrial action until the end of the year.
The RCN is urging members to vote “yes” to strike action, saying it would pressure ministers to improve the pay award for nursing staff and boost staffing levels to keep patients safe.
RCN members rejected the Government’s pay offer in April following several days of strike action since December.
The RCN’s new ballot will be aggregated, meaning the union is seeking a country-wide mandate to allow strikes in every NHS trust or other NHS employer in England where RCN members work.
Any future strikes would involve more than twice as many nursing staff at twice as many locations, said the RCN.
To achieve a country-wide mandate, 50% of all eligible members must vote and the majority must say “yes” to strike action.
The ballot will close on June 23, with the result expected to be announced the following week.
RCN general secretary Pat Cullen said: “Once again, we have been forced to ask our members if they want to take to the picket lines in their fight for fair pay. This is unfinished business and the Government can get it resolved without the need for more strike action.
“Ministers have tried to silence them through the courts as well as in Parliament but we will continue to make sure their voice is heard through the corridors of power.
“The NHS is fraying at the edges. To improve care and address the shortage, Government must bring more people into nursing and keep them there by paying staff fairly.”
Most health unions in England have accepted a 5% pay rise for this year and a cash payment for last year.
Members of the RCN and Unite voted to reject the offer.
Downing Street insisted the Government had made its final offer on pay.
A No 10 spokesman said: “We have offered a fair and generous deal that the RCN themselves recommended to its members and subsequently accepted by the majority of other unions via the NHS staff council.
“We continue to think it’s important that all unions recognise that collective decision and it should be respected.”
The spokesman said Rishi Sunak recognised nurses do “incredible work”, but “what we don’t want to see is patient care impacted any more than it has been with these strikes”.
A Department of Health and Social Care spokesperson said: “We hugely value the work of nurses and it is disappointing the RCN is balloting their members for further industrial action.
“The majority of unions on the NHS Staff Council voted to accept the Government’s fair and reasonable pay offer – which includes a double-digit pay rise of 10.7% over two years for newly qualified nurses.
“We hope RCN members recognise this is a fair deal and decide it is time to bring industrial action to an end.”