A massive 92 percent of those who voted in England said the pay award is unacceptable. In Wales, an even higher 94 percent said no to it.
The size of the No votes is just an indication of the anger among NHS workers of all grades.
The RCN should now move quickly to calling a formal industrial action ballot, with the option of strikes.
Graham Revie, chair of the RCN Trade Union Committee, said, “RCN members have made their voice heard and ministers in Westminster and Cardiff must think again about how they are treating nursing staff.”
But by implementing the 3 percent award without union agreement, the government has already shown that it will not negotiate further.
Unless health workers’ pay rises substantially, there is no way the NHS will be able to fill the tens of thousands of vacancies across the service.
The latest official figures showed 38,952 vacancies in the registered nursing staff group alone.
That means more stress for workers, and worse care for patients.
After 18 months of hell working through the pandemic, thousands of NHS workers are at their wits’ end.
They have come through the initial peaks of Covid-19, in which they’ve had to care for the sick while trying hard to patch up an underfunded and understaffed NHS, only for the government to stab them in the back.
But the health unions have played only a backseat role during that time, and because of that many workers do not see them as a way out of the current crisis.
In a sign that unions have not fully tapped into the anger on wards and in offices, turnout in the RCN ballot was just 25 percent in England and 29 percent in Wales.
The problem is not only with the RCN. It is widely thought that Unison, the NHS’s biggest union, has recorded a similar vote and turnout in its ballot that closed last week.
Unison’s health executive are this week due to discuss the ballot and how to respond.
There is a danger that the only moderate turnout in both unions could see leaders arguing that strikes are not possible because there’s a danger of missing the 50 percent turnout threshold that the Tories’ anti-trade union laws demand.
It is vital that activists across England and Wales argue that the mood of anger in health services can be translated into a good strike vote. Government announcements about the national insurance rise came only at the end of the balloting period and will anger new layers of NHS workers.
And the offcial CPI rate of inflation is now 3.2 percent emphasising that the 3 percent "rise" is a real terms cut. Meanwhile the more accurate RPI rate is 4.8 percent.
Winning a formal ballot will require a lot more effort from the union leaderships, and a concerted plan for how to get the message out to every member in every hospital.