Strikes by NHS staff will go ahead this month after a meeting between union bosses and the health secretary broke down.
Steve Barclay failed to avert further walkouts by nurses, ambulance workers and auxiliary NHS staff during a short meeting on Monday.
Union leaders reacted in anger over the meeting, which had been seen as a breakthrough in relations after the government initially said it would not talk about pay with unions.
Onay Kasab, Unite's national lead, said the government "only wanted to talk about productivity" and there was no detailed discussion on a pay settlement as he confirmed strikes by Unite ambulance workers will go ahead on 23 January.
Mr Kasab said it was "absolutely ludicrous" and "outrageous" the government only wanted to talk about NHS staff being more productive in exchange for a pay rise.
"It's an insult," he said. "Productivity when our members are working 18-hour shifts. Quite how you become more productive, I don't know. I'm very angry on behalf of our members."
'No resolution in sight'
The Royal College of Nursing (RCN) said ministers "have a distance to travel" to avert its second-ever set of strikes on 18 and 19 January.
Joanne Galbraith-Marten, director of employment relations and legal services at the RCN, said: "There is no resolution to our dispute yet in sight.
"Today's meeting was bitterly disappointing - nothing for the current year and repeating that 'the budget is already set' for next year. This intransigence is letting patients down."
'No concrete offer'
The GMB union said no cash offer was made and there was nothing "concrete" offered on pay for the next financial year, which starts in April.
Rachel Harrison, GMB national secretary, confirmed strikes by its members who are ambulance workers will go ahead on Wednesday.
"Today's talks fell well short of anything substantial that could stop this week's strikes," she said.
"There was some engagement on pay - but not a concrete offer that could help resolve this dispute and make significant progress on the recruitment and retention crisis.
"The public expects the government to treat these talks seriously - it's time they got on with it."
Sara Gorten, head of health at Unison, said strikes by ambulance workers who are members will go ahead on both Wednesday and 23 January.
She said it was a step forward to hold discussions with the health secretary and there was a "positive tone", but there was no "tangible" offer from the government.
"For us to call the strikes off will require a firm commitment the Treasury will fix pay for this year as well as next," she told Sky News.
Teachers and rail unions meetings
Teachers' unions also held meetings with the education secretary on Monday, ahead of strike ballot results this week.
Kevin Courtney, joint general secretary of the National Education Union, was slightly more optimistic than the NHS unions but said there was "no sense of concrete progress".
Rail unions had meetings with the transport secretary too, but they all remained tight-lipped.
Mr Barclay is set to talk to the House of Commons on Monday about the government funding an extra £200m to pay for care home beds so people can be discharged from hospital quicker to free-up beds.