Tens of thousands could stage fresh strikes over controversial Government pension reforms after the country's biggest trade union warned fresh action was a "real possibility".
Unite said it planned to ballot its 100,000 members in the NHS with a recommendation they reject the proposals, complaining there had been no substantive changes from what was on the table last year.
Up to two million public sector workers staged a one-day strike in November in protest at the pension changes and, while some progress has been made, the dispute remains unresolved.
Unite said if there is no significant movement by the time of the Government's "self-imposed" deadline of February 20, it will carry out a ballot.
General secretary Len McCluskey said: "There have been no substantive changes from what was on the table before Christmas.
"Our hard-working members will still be expected to pay more, work longer and get less when they retire.
"Our members are deeply unhappy at the Government's stance and we will be holding a consultative ballot to reaffirm our members' position - the prospect of further strike action will be very real, unless ministers move on their hardline position.
"Unite calls, yet again, for ministers to enter into real, genuine and meaningful negotiations on the future of NHS pensions before the deadline of February 20 for talks to end.
"The Government's attacks on public sector pensions are politically-driven, as part of the strategy to privatise the NHS, cut public services, break up the national pay agreements, and disrupt legitimate trade union activities and organisation."
Unite said it had continuing concerns over the high proportion of NHS staff who will see their pension contributions jump from the current 6.5% to 9.3% by 2014/15 and the linking of the NHS retirement age to the state pension age.
Communities and local government minister Bob Neill said there had been constructive discussions with firefighters' unions on the new scheme, which will include average member contributions of 13.2% from April 2015.
"The Government is committed to providing public service pensions that are sustainable, fair and effective," he said.
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