Nurses from emergency departments, intensive care and cancer wards could soon be asked to join their colleagues in strike action.
The Royal College of Nursing (RCN) is understood to be considering action across three days and throughout the night as its dispute with the government escalates.
The union told NHS leaders on Friday that it is preparing to end a process where it had agreed around 5,000 local exemptions from strike action within hospitals.
This would mean nurses in those three departments could become involved, although there would still be a limited provision for the most urgent clinical situations under the union’s legal obligation not to endanger life.
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An RCN source said: “NHS leaders are fearing this escalation, and they must bring pressure to bear on government to get it stopped.
“They were expecting an escalation but had not prepared for the removal of the committees and derogation process that too many had manipulated at local level and applied pressure on nurses to break the strike.”
Dates for the next nurses’ strikes in England could be announced within days, and the action itself could then take place a few weeks later.
England’s nurses walked off the job for two days last week but a strike planned in Wales was called off after the Welsh government improved its pay offer.
In England, Rishi Sunak’s government has indicated it will not negotiate on pay for this financial year.
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Ministers have said they can look at next year’s pay, much to the frustration of union leaders, who say their members need higher pay now to cope with the soaring cost of living.
Nurses are among a number of sectors striking due to the inability of their wages to keep up with rising costs – rail workers, ambulance workers, solicitors, and waste collectors are among those who have walked off the job in the past year.