Hundreds of thousands of NHS workers are to be balloted over strike action in a row over pay it, has been announced.
Union Unison said it is to ask 300,000 of its members to back walkouts following the Government's decision not to accept a recommended across-the-board 1% wage rise for NHS staff.
If approved the industrial action will take place in early October, followed by further waves of strike action.
Hospitals across the country could face disruption if nurses, therapists, porters, paramedics, medical secretaries, cooks, cleaners and healthcare assistants decide to join picket lines.
The union said that the Government's decision not to implement the 1% pay rise recommended by the NHS Pay Review Body would deny 60% of NHS staff and 70% of nurses a pay rise for the next two years.
Christina McAnea, head of health at Unison, said: " Balloting for strike action is not an easy decision - especially in the NHS. But this Government is showing complete contempt for NHS workers.
"It has swept aside the Pay Review Body's recommendations and ignored the union's call for a fair deal. Our members are angry at the way they are being treated and we are left with little choice but to ballot for action.
"We hope to work closely with the other health unions to plan and coordinate action. It is not too late however for (Health Secretary) Jeremy Hunt to agree to further talks, without pre-conditions, to settle the dispute."
The ballot will begin on August 28 and run until September 18.
The Royal College of Midwives (RCM) said it will also ballot its members on whether or not to take industrial action.
It is the first time in the union's history that members will be balloted, a spokesman said.
About 26,000 midwives and maternity support workers working in the NHS in England will be balloted in September with potential industrial action expected to take place in October.
The RCM spokesman said t he action is expected to be a short stoppage followed by action short of a strike.
Members will be asked if they are prepared to take strike action and if they are prepared to take industrial action short of a strike.
"Hard working midwives are deeply concerned that the independent pay review body is being ignored and the NHS pay structure threatened," said RCM chief executive Cathy Warwick.
"Midwives are at the end of their tether. They have already accepted long-term pay restraint and changes to their pension and terms and conditions. Meanwhile they are working harder and harder to deliver high quality care with continuing shortages of midwives and daily pressures on services.
"In the history of the RCM there has never been a ballot for industrial action. Of course it goes without saying that if it is necessary to take action RCM members will not put the safety and care of women and babies at risk.
"NHS staff have to be valued and fairly rewarded for the work they do. Staff that are demoralised cannot deliver the quality of care that NHS users, including mothers and babies, deserve. Investing in staff is an investment in better care. I hope the Government joins the RCM and other unions at the negotiating table, reconsiders their position and seeks a solution."
The Unite union said it will also ballot its members in England, Wales and Northern Ireland over possible strike action in the autumn.
The union, which has around 100,000 members working in the health service, said m embers will be asked whether they wish to take strike action or industrial action short of a strike when they are balloted between August 26 and September 26.
Unite's head of health, Rachael Maskell, said: "We are calling on our members to give us a strong mandate for industrial action.
"This will send a crystal clear message to Health Secretary Jeremy Hunt that he needs to sit down with the unions and listen to our proposals for fair pay for the biggest workforce in this country.
"Industrial action will be carefully calibrated to balance the real and deep anger that our members feel about their falling incomes, with concern for patient care which is paramount for the health professionals we represent."
A Department of Health spokesman said: " NHS staff are our greatest asset and we know that midwives across the country are working hard. That's why they should receive at least 1% additional pay this year and next.
"Since May 2010, there are 1,700 more midwives helping expectant mothers and we want to protect these increases. We cannot afford a general pay rise on top of incremental pay increases without risking frontline jobs.
"We are disappointed that unions are balloting for industrial action. There is still time for the unions to put patients first and accept our offer to come back to the negotiating table."
The news comes as the latest NHS staff earnings for England showed that senior managers in the health service saw a 3.1% pay increase in the 12 months to April 2014.
The average senior manager now earns £77,743, according to the Health and Social Care Information Centre (HSCIC).
The figures, which show the mean annual basic pay for a full time members of staff, show that across the board pay increased by 0.9% with average wages being £29,754.
Most saw a rise in the last year apart from health visitors, ambulance support staff and spe ech and language workers, the figures show.