The union notified NHS leaders, the Department of Health and Social Care, and Downing Street on Friday,  causing concern among Ministers.

The move is intended to break the impasse and avoid months of disruption. Health unions in England are preparing to call for an all-out strike.

After the government ignored the union's calls for better pay for nursing staff, the Royal College of Nursing (RCN) is reportedly preparing to announce more disruptive strikes.

An all-out strike would require previously derogated areas, such as intensive care and emergency departments, to join the picket lines for 48 hours over two days and two nights. The union's move is intended to break the impasse and avoid months of disruption.

According to a NursingNotes poll, the vast majority (71%) support intensifying strike action.

"NHS leaders are afraid of this escalation," a union insider told the newspaper. "They were expecting an escalation but had yet to prepare for the removal of the committees and derogation process that too many had manipulated at the local level. 

They went on to say that bullying by hospital administration was a minor issue during the previous strike.

The DHSC responded to the news by claiming that the Health Secretary was determined to make a "fair and affordable" pay offer in the next pay round rather than revisiting last year's award.

"It is disappointing that the RCN is escalating their strikes," he adds. Patients already feel the effects of the NHS strike action, with over 80,000 appointments canceled.

"Additional walkouts, with less strike-day coverage promised, will exacerbate the impact and put more patients at risk."