Senior doctors are being balloted for strike action as crunch talks between ministers and the rest of the NHS workforce begin on Tuesday.
The Government has finally agreed to pay negotiations with the six trade unions that represent the bulk of the workforce and has assured them extra funding will be made available.
However doctors are excluded from the talks as they are in the middle of a separate contract and the British Medical Association will now ask consultants whether they want to strike.
Consultants earn between £90,000 and £110,000 a year basic pay, being among the best paid NHS staff, but have seen their pay eroded more than most during the last decade.
It comes on top of BMA walk-outs which are already planned for 47,600 junior doctors.
Consultants voted 86% in favour of strike action in a “consultative vote” and will now be invited to take part in a legally mandated ballot.
Dr Vishal Sharma, chair of the BMA consultants committee, said: “In my 25 years in the NHS, I have never seen consultants more demoralised, frustrated and in despair over this Government’s refusal to support the NHS workforce and the patients they serve.
“The Government is refusing to listen to consultants’ concerns, driving many out of the NHS entirely.
“Things will only worsen unless we take a stand.”
Ministers will begin pay talks from today with Union, Unite, GMB, the Chartered Society of Physiotherapy, and the royal colleges of nurses and midwives.
They represent the majority of the NHS workforce on its main Agenda for Change contract and will negotiate collectively.
Unions have agreed not to strike while talks are ongoing and have cancelled walk-outs planned for this week.
The woman leading the NHS unions’ negotiation team told a media briefing that today’s meeting should quickly reveal whether the move by the Tories constitutes “real talks or a stalling tactic”.
Sara Gorton, Unison’s head of health, said: “We will find out within the first few days whether these are serious talks. It will be pretty apparent whether we’re being fobbed off.
“We’re very cautious but also very glad sitting here talking about this rather than the industrial action that we’d be taking on Wednesday.”
She added: “We’ve got a strike date set for March 20 so at some point we will have to make a reassessment of whether there’s progress or not.
“We need to know whether these talks are meaningful, rather than just a tactic to delay and get through the other side of the Budget without having any more industrial action.”
Unions agreed to the pay talks after the Tories agreed to provide the NHS with extra funds for improved pay. Ministers insisted this will take the form of a one-off payment for 2022/23 and an improved pay deal for 2023/24.
The invite from the Government for talks has isolated doctors.
Junior doctors have already been balloted for strike action and will hold their first ever 72-hour walk out from March 13. Also, the first time, emergency cover will not be provided.
Consultants will be asked to fill in for junior doctors during the strike but if they stage their own walk-out it is expected to lead to hundreds of thousands more cancelled operations.
The BMA has announced that consultants will be balloted over potential industrial action on April 17 over pay and pension issues.
The BMA’s consultative ballot was sent to 35,000 consultants.
Matthew Taylor, chief executive of the NHS Confederation, which represents NHS leaders, said: “It is important for all parts of the NHS’s workforce to have the same opportunity to have their concerns around pay understood.
“The danger of not doing this is that the war of attrition between both sides will continue and escalate further, which no one wants.”
Sir Julian Hartley, chief executive of NHS Providers, which represents hospital bosses, said: “Trust leaders urge the government and the BMA to find a resolution quickly.”
