Medical secretaries at York Hospital have moved a step closer to strike action in a long-running pay dispute.
The GMB union was meeting with hospital managers on Tuesday after 98% of the 36 staff who responded to a strike ballot voted in favour of industrial action.
They say a pay structure introduced in 2004 left some secretaries on £2,000 a year less than others in the same job.
York Hospitals Trust has not commented, but the GMB warned that "patients will suffer" if the secretaries walk out.
GMB organiser Joan Keane said the grievances of the hospitals 52 medical secretaries - all women - had never been addressed by the York Hospitals Trust.
She said that as members received their ballot papers the trust had responded by de-recognising the GMB union.
However, she still hoped that negotiations could lead to a deal which would avoid industrial action.
"Hopefully we can reach agreement so that the action does not have to go ahead," she said.
"These secretaries work for the consultants who provide very, very urgent services for members of the public.
"If the secretaries are not available, patients will suffer and that is something nobody wants to see.
"Our members are very concerned about that but feel they have been left with no alternative."