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If they vote yes then hospital porters, nurses, paramedics and cleaners, will be walking out and will be on picket lines this winter. But a ballot of 50,000 Unison members in Scotland, which was already underway, has been suspended after a new offer.

The Government in England has pointed out it had given staff a rise in line with what had been independently recommended by the official NHS Pay Review Body.

In England and Wales, NHS staff have been given an average of 4.75 per cent more, with extra for the lowest paid. But health workers in Northern Ireland are yet to receive the pay award.

Ministers in Scotland upped their initial offer of five percent to a flat rate of just over £2,200. This is worth more than 11 percent to the lowest paid, leading to Unison suspending its ballot there, which had been due to close on Monday.

Unison general secretary Christina McAnea said: “Striking is the last thing dedicated health workers want to do. But with services in such a dire state, and staff struggling to deliver for patients with fewer colleagues than ever, many feel like the end of the road has been reached.  

“The NHS is losing experienced staff at alarming rates. Health workers are leaving for work that pays better and doesn’t take such a toll on them and their families.

If this continues, the health service will never conquer the backlog and treat the millions desperately awaiting care. 

“It feels like the NHS is in the last chance saloon. But a vote for industrial action might be the jolt that convinces ministers to make the NHS the priority they say it is.  

“Strikes across the NHS this winter are not inevitable. The government must start to tackle the growing workforce crisis with an inflation-busting pay rise and get the NHS back on the long road to recovery.”

Unison is not the only health union considering strike action this winter. Others, including the Royal College of Nursing, Royal College of Midwives, GMB and Unite, are all in the process of, or are planning to, ballot their members.

A Department of Health and Social Care spokesperson said: “We are giving over one million NHS workers a pay rise of at least £1,400 this year, as recommended by the independent NHS Pay Review Body, on top of three per cent last year when pay was frozen in the wider public sector.

“Industrial action is a matter for unions, and we urge them to carefully consider the potential impacts on patients.”

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