Nurses in England have failed to vote in sufficient numbers for further strike action after the nursing union leader raised concerns that they were deterred by mandatory postal voting.

The Royal College of Nursing had sought a fresh mandate for industrial action over pay until Christmas through a ballot of more than 300,000 nursing staff across England, which closed on 23 June.

With an overall turnout of 43.4%, the ballot fell short of the 50% of union members voting required by 2016 trade union laws for the result to stand, equivalent to more than 150,000 of the RCN’s membership.

In the ballot, more than 100,000 RCN members voted in favour of strike action – about 84% of the total number who voted.

To clear the turnout threshold, approximately 140,000 ballot papers needed to be returned in the post but only 122,000 were received by the closing date on Friday.

The RCN general secretary and chief executive, Pat Cullen, said in an email to members that the result would be “disappointing for many of you”, but that the fight for fair pay and safe staffing “is far from over”.

She said: “This week, the government will say it has a plan for the NHS workforce. I am seeing the prime minister this afternoon to hear him out and to ask him the questions you wanted answering on his commitment to nurses and support workers.

“I know staff morale is low and the staffing crisis is set to worsen without immediate action. I will be telling him this today. We have started something special – the voice of nursing has never been stronger and we’re going to keep using it.”

The RCN said it would continue to campaign for fair pay, and that members would hear more soon on new campaign activity and how they can apply pressure and secure meaningful changes to job descriptions, roles and levels of pay.

The RCN added that members working on Agenda for Change contracts in the NHS in England would not be balloted again about the 2022-23 or 2023-24 pay offer.

The RCN – along with Unite – rejected the government’s pay offer of 5% and a one-off payment of at least £1,655, which was accepted by several other unions and arrives in pay packets this month. This was on top of the average 4.75% pay rise NHS staff had received in 2022-23.

Before the results, Cullen suggested an affirmative result was in doubt since she did not think sufficient numbers of members would get their postal votes in on time due to union laws preventing online voting.

Nurses have taken strike action three times since December but the RCN needed the support of its members at another ballot to continue strikes. This ballot also sought a countrywide mandate, rather than at individual trust level. A vote in support would have given the RCN a mandate to strike in every NHS trust or other NHS employer in England where members work.

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The chief executive of NHS Providers, Julian Hartley, said that despite the outcome of the vote “we must not ignore the strength of feeling within the profession and the factors that compelled them to walk out in the first place”.

He said trust leaders would be “hugely relieved” there were no nursing strikes to plan for, but that they hoped the government and RCN would be able to rebuild their relationship with a view to resolving “wider, ongoing issues affecting the NHS workforce, including understaffing and burnout”.

“Anything less risks compounding the damaging legacy of increasingly long and drawn out industrial disputes between the government and different groups of healthcare staff,” he said.

A Department of Health and Social Care spokesperson said: “We hugely value the work of nurses and welcome the end to hugely disruptive industrial action so staff can continue caring for patients and cutting waiting lists.

“More than a million eligible NHS staff are receiving their pay rise and one-off payments this month, with an experienced nurse receiving over £5,100 in extra pay across last year and this year. We are committed to supporting nurses to continue to progress and develop, including as part of the upcoming NHS long-term workforce plan.

“We hope other unions who remain in dispute with the government recognise it is time to stop industrial action and move forward together.”

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