Nurses across Cumbria are to stage fresh strikes after rejecting the Government's pay offer in a shattering blow to hopes of resolving the bitter NHS pay dispute.

The Royal College of Nursing (RCN) announced that its members including those who work for University Hospitals of Morecambe Bay NHS Foundation Trust and NHS Lancashire and South Cumbria ICB will walk out for 48 hours from 8pm on April 30.

It will be without any derogations, which means nursing staff working in emergency departments, intensive care units and cancer care will be taking industrial action for the first time.

The escalation followed a 54 per cent vote to reject an offer of a five per cent pay rise this year and a cash payment for last year.

The turnout among RCN members employed on NHS Agenda for Change contracts in England was 61 per cent

The move followed an earlier announcement by Unison that its NHS members had accepted the same offer by 74 per cent on a turnout of 53 per cent.

Unison's head of health, Sarah Gorton, said the vote did not solve the 'staffing emergency' in the NHS.

RCN general secretary Pat Cullen has written to Health Secretary Steve Barclay to seek urgent re-opening of talks with the Government.

She said: "What has been offered to date is simply not enough. The Government needs to increase what has already been offered and we will be highly critical of any move to reduce it.

"Since our talks in February, we have seen the pressures on the NHS continue to increase.

"The crisis in our health and care services cannot be addressed without significant action that addresses urgent recruitment and retention issues and nursing pay to bring this dispute to a close urgently.

"Until there is a significantly improved offer, we are forced back to the picket line.

"Meetings alone are not sufficient to prevent strike action and I will require an improved offer as soon as possible. In February, you opened negotiations directly with me and I urge you to do the same now.

"After a historic vote to strike, our members expect a historic pay award."

The ballot results were announced as junior doctors in England staged the final full day of a 96-hour strike in a separate row over pay.