There could be "massive" industrial unrest if health workers are not given a decent pay rise after being hit hard by the Government's wage freeze, ministers have been warned.
Unions told the NHS Pay Review Body (PRB) that the two-year pay freeze, followed by planned increases of 1% a year from next April, was inflicting "long-term damage" to the NHS.
In evidence to the review body, unions called for support for the Agenda For Change national pay system if industrial unrest is to be avoided across the UK in the coming year.
Unison, which represents 450,000 NHS staff including nurses, midwives, cooks and cleaners, said the pay of health workers will have fallen by up to 12% in real terms by next April because of the Government's policies.
Christina McAnea, the union's head of health, said: "NHS staff are being hit from all sides. There are massive cuts to services and to jobs despite the fact that demands on the NHS are growing year by year.
"Inflation is taking a heavy toll on staff and their families, who have not had a pay rise for two years, while inflation is taking chunks out of their pay. We are urging the PRB to recognise the long-term damage that the coalition's pay policy is inflicting on the NHS.
"To add insult to injury, Trusts, like those who are members of the South West pay cartel, are planning to make cuts to the national terms and conditions of their staff to help them make the massive savings the Government is demanding.
"We are calling on the PRB to make its strong support for Agenda for Change clear or face the consequence that these rogue elements will threaten to stir up massive industrial unrest across the whole of the NHS."
Unison said increased pension contributions were likely to lead to a further reduction in take-home pay of up to 6% by 2015.