Consultant doctors have narrowly rejected the pay offer from government in a ballot.
In a British Medical Association ballot which closed yesterday, 51 per cent of respondents rejected the offer, with 49 per cent voting to accept.
The turnout was 65 per cent.
No further strike action has yet been announced.
The latest offer from ministers would not have changed the headline pay increase of 6 per cent which was previously rejected by unions, but would have meant an additional investment of around 3.5 per cent into the pay scale structure.
This would have increased the starting pay for new consultants, increasing the top pay point, and shortened the length of time it takes to reach the top of the pay scales by five years.
BMA leaders agreed in November to put the offer to members. It was not explicitly recommended by leaders, but the BMA did issue various rebuttals to claims made by critics of the deal.
The union said in a statement: “The results have been discussed by consultants committee today and we have decided not to call strike action at the current time but instead enter discussions with government to see whether we can secure improvement to address your concerns.
“If, however, that is unsuccessful, consultants in England remain in dispute; as members demonstrated in the ballot before Christmas they remain committed to taking further strike action, should the need arise. We want this dispute resolved, but the ball is in the government’s court to make a renewed offer that not only delivers for consultants, but crucially, for patients too, by retaining the NHS’s most experienced clinicians.”
Health secretary Victoria Atkins said: “I hugely value the work of NHS consultants and I am disappointed that after weeks of constructive negotiations the BMA has, by the narrowest of margins, rejected this fair and reasonable offer.
“I want to build on our progress on waiting lists and for us all to be able to focus our efforts on offering patients the highest quality care. The Government is therefore carefully considering next steps.”