Further talks are to be held to try to prevent ambulance crews taking industrial action in a dispute over pay during meal breaks.
Workers want to be paid if interrupted during meal breaks
North East Ambulance Service Trust (NEAS) staff were offered a rise of up to £1,800 to be on call during breaks.
Union Unison rejected the offer with 80% of its staff voting in favour of action, including an over-time ban.
Further talks are be held over the next few days to try to resolve the row before action begins on Monday.
NEAS chief executive, Simon Featherstone, said he was "bitterly disappointed" by the proposed action.
In November, the ambulance trust introduced a £20 payment as an interim measure for crews who volunteered to answer 999 calls during their meal breaks.
But Unison believes staff should be paid time and a half if they are called out during breaks or be allowed to be off duty.
Dave Armstrong, Unison regional officer, said: "The vote was to take action over a management imposed meal break policy, which is in breach of the national Agenda for Change agreement.
"It is disappointing that we have not reached agreement with North East Ambulance over meal breaks."
Mr Featherstone said: "I am bitterly disappointed at the outcome of this ballot. We have made significant efforts to resolve the meal break issue locally, yet all our offers have been rejected.
"I have tried really hard to resolve this dispute with a generous offer, but I cannot break the national agreement.
"We will have to try and minimise the damage this unnecessary action may cause."