A nursing union leader is demanding a double-digit pay rise amid the threat of more strikes lasting until Christmas.

Pat Cullen, head of the Royal College of Nursing, previously advised her union's members to accept a pay rise of five per cent offered by the Government – before 54 per cent of them voted against it.

Now, in a U-turn on her earlier position, Ms Cullen says fresh talks on a percentage pay rise need to 'start in double figures'. Her call for Health Secretary Steve Barclay to reopen negotiations comes as senior doctors in England start voting today on whether to strike in the continuing dispute over pay.

Yesterday Cabinet minister Grant Shapps said: 'Pat Cullen just recently was encouraging her members to settle for the pay rise that was put on the table, that would see £5,000 go into the pockets this year of hard-working nurses.

'It is confusing that she seems to now be coming back and saying the opposite.'

Speaking ahead of the annual RCN congress in Brighton, which began yesterday, Ms Cullen told The Sunday Times fresh negotiations were needed to prevent six more months of industrial action.

She said: 'They [ministers] owe that to nursing staff not to push them to have to do another six months of industrial action right up to Christmas.'

The majority of unions making up the NHS Staff Council voted earlier this month to accept the five per cent pay deal and a one-off bonus of up to £3,789 for last year.

But RCN members voted against the recommendation to accept it, so will keep pushing for a higher wage rise.

The union is set to reballot its members on May 23 for further strike action.