Nurses have moved a step closer to taking industrial action over pay, it has emerged.
The call comes after Royal College of Nursing (RCN) delegates overwhelmingly passed a motion at the body's conference over the possibility of industrial action.
The motion said that in the event of an attack on any pay deal, members will be balloted on industrial action.
The large majority of members also voted in favour of a motion of no confidence over Health Secretary Andrew Lansley's handling of NHS reforms.
Health minister Anne Milton infuriated nurses earlier in the week when she said an offer was still on the table for no compulsory redundancies in return for nurses accepting a two-year pay freeze when they move up pay bands in accordance with their experience.
The proposal, made by NHS Employers last year, was rejected by all major health unions including Unison, the British Medical Association and the RCN.
The RCN described the proposal as an "attack on hard-working nurses" and said NHS Employers had been unable to even guarantee that more than 100 trusts would stick to any agreement on no compulsory redundancies.
But Ms Milton told nurses the proposal was still there, adding: "These are difficult times and we are walking a financial tightrope."
She said opting in to the pay freeze would mean no compulsory redundancies for nurses in pay bands one to six and "as few as possible for other staff".
The motion, which was passed 97% in favour to 3% against, said the RCN should ballot members on industrial action if there was any "imposition" of an incremental freeze or any other proposal which challenged nurses' national pay agreement.
Some 438 nurses voted in favour, 14 against and eight abstained.
RCN Chief Executive, Dr Peter Carter, said the vote was "a symptom of nurses feeling that the government may be listening but they are not hearing".