Responding to the outcome of the pay ballot by the British Medical Association (BMA) specialist, associate specialist and specialty (SAS) doctors in England, the deputy chief executive of NHS Providers, Saffron Cordery said:

"Trust leaders will understandably feel dismayed by this outcome of this vote.

"Following the consultants' narrow rejection of their pay deal, they had hoped the dispute between the government and SAS doctors would have a different result. But today's resounding vote against the deal makes clear that a range of concerns still need to be addressed.

"It is positive that the BMA SAS committee will now survey members to find out which aspects of the offer they want to see improved.

"It is vital that hard won progress made towards an agreement is not lost.

"It is worrying though that the prospect of further strike action continues to loom over the health service, with junior doctors currently re-balloting on strike action and action short of strikes.

"Politicians and unions must find a way to resolve all disputes for the sake of patients and the NHS."