A ballot of around 100,000 NHS members of the Unite union is under way over possible strike action this winter in protest at a below-inflation pay offer.
Voting by Unite members in England and Wales began as the Royal College of Nursing (RCN) announced almost half a million members will also take part in a separate strike ballot next month.
Both unions are recommending their members support industrial action, which could begin in October and throw the health service into crisis over the winter.