Nurses in England have voted to reject the government’s offer of a 5.5% pay rise, the Royal College of Nursing (RCN) has said.

Members of the RCN rejected the deal by two-thirds in a record high turnout of around 145,000.

The pay award for 2024-2025 was announced by the chancellor at the end of July, shortly after Labour won the general election.

In a letter to Health Secretary Wes Streeting, RCN general secretary Prof Nicola Ranger said nursing staff were determined to “stand up for themselves, their patients and the NHS”.

The RCN said the high turnout surpassed the level seen in two ballots for industrial action held by the union in 2022 and 2023, the first of which permitted six months of strike action by nursing staff.

The union argues that the pay of an experienced nurse fell by 25% in real terms under the Conservative governments between 2010 and 2024.

Prof Ranger said nurses “do not feel valued”, adding they were concerned by “understaffed shifts, poor patient care and nursing careers trapped at the lowest pay grades”.

As ministers prepare to set out a new health and social care agenda, Prof Ranger added: “The government will find our continued support for the reforms key to their success.”

She said the government will need “safe numbers of nursing staff” who “feel valued” if they are to “raise standards and reform the NHS”.

The announcement follows a vote last week by junior doctors to accept a multi-year pay rise to end their long running dispute.

At that time, Prof Leader said: “We do not begrudge doctors their pay rise.

“What we ask for is the same fair treatment from government.”

Members of other health unions have accepted the 5.5% pay deal, which is for 2024/25.

Health and Social Care Secretary Wes Streeting said: “We know what nurses have been through in recent years and how hard it is at the moment. That’s why, despite the bleak economic inheritance, the Chancellor awarded them with an above-inflation pay rise.

“For the first time in a long time, nurses have got a government on their side, that wants to work with them to take the NHS from the worst crisis in its history, to get it back on its feet and make it fit for the future. We will work with NHS staff to turn this around together.”