Nursing staff at the majority of NHS employers across the UK have voted to strike over pay.

The Royal College of Nursing (RCN) said industrial action will take place in the NHS trusts or health boards that have met the legal requirements.

Many of the biggest hospitals in England will see strike action by RCN members but others narrowly missed the legal turnout thresholds to qualify for action.

All NHS employers in Northern Ireland and Scotland will be included and all bar one in Wales met the relevant legal thresholds.

Anger has become action - our members are saying enough is enough

Guys and St Thomas’ in London, opposite the House of Commons, appears in the list as well as other leading hospitals in capital cities of the UK – the Royal Infirmary of Edinburgh, University Hospital Wales in Cardiff and Royal Victoria Hospital in Belfast.

This is the first statutory ballot on industrial action across the UK in the 106-year history of the RCN.

Industrial action is expected to begin before the end of this year and the RCN’s mandate to organise strikes runs until early May 2023, six months after members finished voting.

RCN general secretary Pat Cullen said: “Anger has become action – our members are saying enough is enough. The voice of nursing in the UK is strong and I will make sure it is heard. Our members will no longer tolerate a financial knife-edge at home and a raw deal at work.

“Ministers must look in the mirror and ask how long they will put nursing staff through this. While we plan our strike action, next week’s Budget is the UK Government’s opportunity to signal a new direction with serious investment. Across the country, politicians have the power to stop this now and at any point.

“This action will be as much for patients as it is for nurses. Standards are falling too low and we have strong public backing for our campaign to raise them. This winter, we are asking the public to show nursing staff you are with us.”

Health Secretary Steve Barclay described the results of the ballot as “disappointing”.

“We are all hugely grateful for the hard work and dedication of NHS staff, including nurses, and deeply regret that some union members have voted for industrial action,” he said.

“These are challenging times, which is why we accepted the recommendations of the independent NHS Pay Review Body in full and have given over one million NHS workers a pay rise of at least £1,400 this year.

“This is on top of a 3% pay increase last year when public sector pay was frozen and wider government support with the cost of living.

“Our priority is keeping patients safe during any strikes. The NHS has tried and tested plans in place to minimise disruption and ensure emergency services continue to operate.”

Sara Gorton, head of health at Unison, which is currently balloting its members in the NHS for strikes, said: “This is loud a wake-up call to the Government.

“Hundreds of thousands more nurses, paramedics, cleaners, health care assistants and other NHS employees are still to decide if they’ll be striking for better pay and staffing. Now is the time for swift action to avoid a damaging dispute.

“A strike across the NHS this winter isn’t inevitable. Unions want to work with ministers to solve the NHS staffing crisis and its impact on patient care but that must start with another pay rise for health workers. Otherwise, delays and waits for patients won’t reduce.

The NHS cannot keep patients safe without improving staffing levels. Boosting pay is a crucial first step in dealing with the NHS workforce crisis

“A second wage increase in line with rising prices would ensure staff can provide for their families. It would also stop experienced employees leaving so the NHS can keep caring for patients.

“Inflation has already wiped out this year’s 72p-an-hour increase. Threats of wage caps next year to make good the damage caused by the previous government’s economic incompetence will only make a bad situation significantly worse.

“NHS managers are fighting a losing battle. They know pay and the lack of staff are the main reasons why health workers are leaving at alarming rates.

“The NHS cannot keep patients safe without improving staffing levels. Boosting pay is a crucial first step in dealing with the NHS workforce crisis.

Wes Streeting, shadow health secretary, said: “There were no strikes in the NHS during 13 years when Labour was last in government. If we were in office today, we would be talking with the RCN and doing everything we can to prevent these strikes going ahead.

“Government ministers spent the summer dodging calls and requests for meetings from the Royal College of Nursing. It is unacceptable negligence.

“The Conservatives have stopped governing and it is nurses and patients who will be made to pay the price.”

Dr Emma Runswick, deputy chairwoman of the BMA (British Medical Association) council said: “Doctors offer our support and solidarity to nursing colleagues following this historic ballot for industrial action.

“Like us, nurses are showing that they have had enough of being undervalued by this Government.

“Along with other frontline healthcare workers, nurses have borne the brunt of an understaffed and under-resourced health service, where despite their best efforts and working at their absolute limits, healthcare staff are too often unable to provide patients with the care they need.

“This Government has responded by repeatedly cutting their pay in real terms and causing genuine hardship for many.

“It is still within the Government’s gift to pay healthcare staff fairly for the vital, often lifesaving work that they do.

“We urge Government to listen to the concerns of frontline health staff and deliver the investment that the NHS and its workforce so desperately need.”

We need to see the detail of what any action might look like but trust leaders will do all they can to minimise disruption for patients

Interim chief executive of NHS Providers, Saffron Cordery, said: “Trust leaders have been planning for possible strikes. Their priorities are to ensure the safe delivery of care and services for patients during any industrial action and to support the wellbeing of their staff.

“We need to see the detail of what any action might look like but trust leaders will do all they can to minimise disruption for patients.

“We understand just how strongly nurses feel and why they’ve got to this point: below-inflation pay awards amid the rising cost of living, severe staff shortages and ever-increasing workloads.

“The Government needs to sit down with union leaders to find an agreed solution as soon as possible. Prolonged action is something everyone wants to avoid.”

Helen Whyley, director of RCN Wales, said: “Today is a historic day for the nursing profession, our patients, and the future of nursing but ultimately one born of desperation.

“The decision to strike, has in not been taken lightly, and has passed to demand change where no other solution has been possible”.

“Our members have spoken on what is an incredibly difficult decision both professionally and personally. The result of this ballot shows just how much nursing staff put the safety of their patients above all else.

“Over the last few weeks of our campaign I have been overwhelmed by the support our members and the public have shown. I have visited hospitals and workplaces throughout Wales. I have heard first-hand of nurses who are struggling to pay their household bills, of the extra hours they have worked for free to subsidise the NHS, the shifts they have gone without any breaks.

“They have told me of their constant worry and despair for the safety of their patients due to short-staffing.

“There is currently no escape for staff, worry and guilt for their patients at work, worry and guilt for their families at home. This is not sustainable.

“Many have told me that they cannot continue in their beloved profession without change.”