Nurses are to be balloted on whether they would be prepared to support industrial action over pay.
The Royal College of Nursing (RCN) is sending papers to almost 200,000 members in England asking them whether they wish to be balloted on industrial action.
The move comes after the Government announced earlier this year it would be staging the 2.5% pay award.
It offered nurses in England, Wales and Northern Ireland a 1.5% pay rise in April followed by a further 1% rise in November.
But devolved administrations in Northern Ireland, Wales and Scotland have agreed to pay the rise in full in one go.
Nurses in England are still being offered the staged rise - which adds up to 1.9% over the year.
The RCN has released a poll of more than 2,300 people showing that 74% would support nurses taking some form of industrial action on pay.
More than eight in 10 (82%) also believed the pay award for nurses was unfair.
The RCN estimates that the Government will save around £60 million by keeping to the staged award.
But if nurses withdrew their goodwill and called a halt to working unpaid overtime, the NHS would be obliged to provide cover through agency or bank nurses, the RCN said, costing a minimum of £13 million every week.
