Unions representing more than a million NHS workers have pulled out of the government's pay review process in a bid to negotiate reforms to salary bands and structure.
Almost every union that represents staff on Agenda for Change contracts is taking part in the boycott.
These contracts are for workers who aren't doctors or dentists.
This row seems to be far off from industrial action, and is more about changing what the unions view as an outdated structure for pay.
But there is still a warning for ministers - with the unions saying that "discontent with the 2025 pay award and the broken promises on talks have heightened industrial tension and time is running out".
They want to sit down with bosses and ministers to ensure workers are in the right pay band, as well as discussing payrises - a process they believe is too complicated and nuanced for the pay review body process.
They also want to see investment into the NHS.
Pay review bodies make recommendations on public sector payrises based on evidence provided by government, unions and other stakeholders.
Helga Pile, who is chair of the NHS unions and Unison head of health, said: "The government promised talks over a year ago and they still haven't got round the table with unions with any proper plan to sort things out."
She added: "Some things need sorting urgently while others will take longer to work through. But the important thing is that we agree a plan and get the funding needed to reach a deal.
"The health secretary wants a more efficient system and that begins with getting pay right. Tackling this now will help to deliver the pay rise when it's due in April rather than kicking the can down the road leaving staff with months of delays."