The public services union, Nipsa, is to ballot healthcare members for industrial action over pay and conditions.

Following a meeting between union leaders and Health Minister Robbie Butler, they said it was "clear that the time for talking is over", with Nipsa assistant secretary Kevin Kelly stating health workers had "reached a tipping point".

The union has been demanding this year's pay award to be implemented immediately, alongside pay reform parity with other regions in the UK and the extension of the Real Living Wage to those in the care sector.

The Department of Health said implementing the 2026-27 pay award and Real Living Wage would cost about £280m.

Nipsa has been holding meetings with members working across the health service and said they had given a clear message over their frustrations.

In its letter to healthcare members, Nipsa said workers should "not have to face increasing workloads, unsafe staffing levels, threat to jobs and continued cuts to vital services".

The union said it was now progressing legal steps to hold the ballot, which will run from 21 October and close next month.

"Our members are telling us they have had enough of being asked to do more with less while services are cut, staff go unrecognised and pay issues remain unresolved," Kelly said.

He added that workers are still waiting for the 2026-27 pay award, with many low-paid staff waiting for the Real Living Wage. He said there remains ongoing frustration around pay reform parity.

"At the same time, the Executive is expecting health and social care organisations to deliver cuts of more than 12% over the next three years. Our members have been crystal clear. Enough is enough," Kelly added.

Last year's pay offer was also delayed, with the Department of Health making the offer in November in order to avoid threatened industrial action.

At that stage, £200m was signed off for the pay deal.

Health pay is a devolved matter in Northern Ireland.

The Department of Health has said that it currently faces a deficit of between £800m to £1bn.

This week, officials told Stormont's health committee that because the NI Executive had still not agreed a budget, they were continuing to base their financial plans on the multi-year budget paper issued in April.