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More than 15,000 ambulance workers, including many in Kent, are to begin voting later this month over strike action.
The GMB union has confirmed it is preparing to ballot close to 20,000 of its members at 11 ambulance trusts across the country, including South East Coast Ambulance Service, because of a dispute over pay.
It has been 'decades', says the union, since ambulance teams last opted for industrial action but with cuts and staff shortages an ongoing issue and growing discontent at a 4% pay offer, it says its workers have 'had enough.
Rachel Harrison, GMB National Officer, said: "Ambulance workers have just had enough. They’ve not been on strike in decades, but they are at the end of what they can take.
"Pay has been systematically slashed for more than 10 years and we now face the worst cost of living crush in a generation.
"Meanwhile vacancies are at record highs and we have the worst A&E delays ever - and it’s not even the winter flu season yet.
"But this is about more than pay and conditions. Cuts and shortages mean GMB members feel they are unable to deliver safe standards of patient care."
Ballots will open on October 24 and close on November 29. Any potential strike action could take place before Christmas, added the union.
Ambulance workers are not the only frontline healthcare workers embarking on strike ballots. They are joining hundreds of thousands of nurses which are also currently being asked if they too want to walk out in rows over pay.
It is the first time in its 106-year history the Royal College of Nursing has balloted members over strike action, and the union is encouraging its members to say in the vote, which closes in early November.
The ambulance trusts where GMB members will be balloted are:
London Ambulance Service NHS Trust
East of England Ambulance Service NHS Trust
East Midlands Ambulance Service NHS Trust
West Midlands Ambulance Service NHS Trust
North East Ambulance Service Trust
Yorkshire Ambulance Service NHS Trust
North West Ambulance Service NHS Trust
South Central Ambulance Service
South East Coast Ambulance Service
South West Ambulance Service
Welsh Ambulance Service NHS Trust.