Members of Northern Ireland's largest health workers' union have voted to strike.
Unison represents about 25,000 healthcare workers including nurses, social care staff, support services but not doctors.
Its membership was asked to vote on a strike over pay and safe staffing levels. The turnout was 23%.
The BBC understands the first strike action will be taken around 25 November.
The union is expected to meet on Friday to finalise details for a comprehensive industrial action plan which includes strikes.
It comes after nurses in Northern Ireland voted to strike last week - the first time in the Royal College of Nursing's (RCN) 103-year-history that such action has been taken in the UK.
'Pushed to the brink'
Unison said pay and safe staffing levels had been a "key contributing factor in the now crisis level in waiting lists and waiting times for patients across Northern Ireland".
"The message from Unison members is clear. They are no longer prepared to accept the lowest pay levels in the UK, the greatest number of frontline vacancies and the highest waiting lists."
Patricia McKeown, the union's regional secretary, said workers "do not take industrial action lightly, but have been pushed to the brink".
"Responsibility for averting this critical situation lies with the Department of Health, the head of the NI Civil Service and the Department of Finance.
"They must access the funding necessary to resolve the pay problem and to address safe staffing levels as a matter of extreme urgency.
"Their current proposals are rejected by us as wholly inadequate."
Health budget 'overcommitted'
The Department of Health said it remained "focused on finding a way forward" and was finalising a formal pay offer for 2019/20.
"This will be the best offer possible within the budget available, but the reality is that our ability to address pay issues is inevitably constrained at a time of intense budgetary pressures for health and social care services.
"These budgetary pressures are clear for all to see and we have been highlighting these for some considerable time.
"Despite claims to the contrary, there is no separate or untapped source of funding that we can access - nor can money simply be found in the budget.
"As with any other item of expenditure, pay costs come out of the one health budget which is currently overcommitted. Every £1 spent on one priority area is £1 not available for another."