Pay talks for NHS workers in England have stalled, increasing the threat of strike action, after the latest round of negotiations on Wednesday ended without reaching agreement. 
The Pay Review Body awarded NHS workers a pay rise of 2.5% in April, but the government insisted that public sector pay awards be no higher than 2% for this year, in line with inflation.
The money was consequently offered in two stages -- 1.5% in April and a further 1% in October.
But workers in all other parts of the UK will receive the full sum, with Northern Ireland's Executive the latest to relent, backdating the award to April.
Unless agreement can be reached, Unite, the health sector section of Amicus, will recommend rejection of the current pay deal and will ballot its members on taking industrial action, said Kevin Coyne, Unite head of health.
"It is unacceptable that workers in England should be treated differently and contrary to the Pay Review Body's recommendations," he said.
Unite represents 100,000 workers, including theatre nurses, health visitors, pharmacists, mental health practitioners, and sexual health advisors, as well as healthcare scientists, dental staff and opticians.
Unison lead negotiator, Mike Jackson, said: "Health workers feel a strong sense of injustice that the government has welched on a deal and is trying to impose a pay cut in real terms."
Unison's members include nurses, porters, and cleaners.
A 2.5% pay award was already well below inflation, he said, adding that staging it reduced its value to 1.9%. "Our health workers deserve better and need more to just keep up with the rising cost of living."
Unison's Health Service Executive will meet in Manchester next week to decide whether to ballot the membership about taking industrial action.
The Royal College of Nursing has already asked its members if they want to proceed to a formal ballot to decide whether to go on strike.
A spokesperson for NHS Employers, which is negotiating on behalf of the government, said that there was a lot of behind the scenes activity and that all sides were "still talking."