Senior doctors are prepared to strike in protest over their pensions and deep cuts to their pay, a consultative ballot by their union has shown. The indicative ballot run by the British Medical Association (BMA) found that 86% of more than 17,000 consultants in England who voted would go on strike. The doctors’ union has warned ministers that unless they begin “meaningful negotiations” by 3 April, it will launch a fresh ballot that could give it the legal right to order walkouts. Strikes by consultants as “a last resort” could start in May, the BMA said. Meanwhile, unions representing NHS staff except doctors and dentists will on Tuesday begin three days of intensive negotiations with the government amid growing hopes that they can resolve the pay dispute that has triggered a wave of recent strikes. Six unions will meet ministers and officials from the Department of Health and Social Care (DHSC), including the health secretary, Steve Barclay, to try to thrash out a deal to agree a belated pay boost for 2022-23 and the size of the annual rise that NHS staff will get in 2023-24. The NHS minister, Will Quince, will also be among those taking part in the talks, and government sources say they believe a deal can be struck by Thursday. Unions agreed to a government precondition of calling off their strikes, including some planned for ambulance services this week, in order to kickstart detailed negotiations. Consultants’ salaries have fallen by almost 35% in real terms since 2008-09, while a longstanding “pension tax trap” is forcing experienced doctors to quit, the BMA claims. “Our door remains open; it is not too late to stop consultants from acting. But if the government refuses to propose a workable solution, our members have made it clear that they are prepared to strike”, said Dr Vishal Sharma, the chair of the BMA’s consultants committee. NHS leaders, who are already preparing for a 72-hour strike by junior doctors starting next Monday, reacted with apprehension to the prospect of its most senior medics withdrawing their labour. “This move by consultants is another worrying development for NHS trust leaders, on top of the looming three-day strike by junior doctors. Strikes by consultants would heap yet more pressure on overstretched services,” said Sir Julian Hartley, the chief executive of NHS Providers, which represents health service trusts. He urged the BMA and ministers to “find a resolution quickly”. The strikes involving nurses, ambulance staff and physiotherapists that have taken place since mid-December have forced the NHS in England to cancel more than 100,000 hospital outpatient appointments and planned operations. A stoppage by consultants would increase that number dramatically, given their key role in hospitals. “Confirmation that consultants have voted in favour of holding a future ballot for strike action will be concerning to health leaders,” said Matthew Taylor, the chief executive of the NHS Confederation. “If this is the strength of feeling from consultants now, the worry is that some could be less inclined to cover shifts during the upcoming junior doctors strikes next week, leaving patient care at increased risk.” Hospitals will be reduced to offering only a much-reduced service if senior doctors do stage stoppages. “Strike action by consultants will mean consultants running a ‘bank holiday’ service on weekdays, ensuring that emergency or urgent care remains in place,” the BMA said. Unions and Barclay will discuss how big a one-off payment staff should receive to help bridge the gap between the £1,400-a-head award Barclay imposed on them and the rising cost of living, which has seen inflation go above 11% over the last year. They will also negotiate how much higher their pay rise next year should be than the 3.5% already planned by the government. Unions say Barclay has found “significant” amounts of extra cash from within his own departmental budget to enable him to make improved offers to staff for both years.