Nurses in Scotland have overwhelmingly rejected the latest pay offer from the Scottish Government, in a move that could see members of the Royal College of Nursing (RCN) take strike action for the first time ever.
Leaders of the RCN had balloted their members after ministers at Holyrood offered a "best and final" improved pay rise.
After 82% of those who took part in the ballot rejected that offer, the RCN said it would announce dates for strike action in Scotland early in the new year.
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Julie Lamberth, RCN Scotland board chair insisted: "Make no mistake - we do not want to go on strike.
"Years of being undervalued and understaffed have left us feeling we have been left with no option because enough is enough.
"The ball is in Scottish Government's court if strike action is going to be avoided."
The Scottish Government had offered workers in the NHS a pay rise that would have seen staff receive an average increase of 7.5% - with the lowest paid staff to get a rise of 11.3%.
Ms Lamberth said putting the improved offer to nurses was "the right thing", as she added the result of the ballot "could not be clearer".
She said: "We have forcefully rejected what the Scottish Government said is its 'best and final' offer."
The Royal College of Midwives also announced its members had rejected the offer, with almost two-thirds (65%) having voted against the deal which it claimed would see many midwives "actually worse off in real terms".
It has also been rejected by staff in the GMB trade union - although it has been accepted by workers in both Unite and Unison.
Jaki Lambert, RCM director for Scotland, said: "Our members have spoken loud and clear - the latest pay offer by the Scottish Government is simply not good enough.
"It goes nowhere near addressing the rising cost of living and would see many midwives actually worse off in real terms.
"Our maternity services are continuing to face staffing challenges. In many places, it's only the goodwill and commitment of midwives and their colleagues that keep these services going."
She added: "We have written to the Cabinet Secretary and said that it's not too late to avert strike action - we just need to get back around the table."
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