STRIKING hospital workers have voted to escalate their industrial action, after rejecting offers of talks.

Bosses at the City of Sunderland Hospitals NHS Trust have been told that the health union Unison is stepping up medical secretaries' action over pay.

More strikes could follow at hospitals throughout the region.

The union has already organised a three-day strike at the 1,000-bed Wearside trust, which includes Sunderland Royal Hospital and Sunderland Eye Infirmary.

More than 130 medical secretaries joined picket lines yesterday morning and cheered and waved placards as a steady stream of passing motorists honked their horns in support of their pay claim.

Now Unison is deepening the dispute, calling another strike next week, but this time for four days.

Liz Twist, the union's regional head of health, said the decision to hold the four-day strike from next Tuesday was taken at a meeting of medical secretaries.

"They have been heartened by the warmth of support shown by patients and the public and they are determined to persuade the Sunderland trust management that their claim for regrading cannot be ignored," she said.

Debbie Wallace, a medical secretary who earns £13,000 for a demanding full-time job, said: "We will stick out for as long as it takes. The feeling is so strong."

She said it was unfair that medical secretaries in Carlisle, Scotland and parts of the South-East of England were now being paid thousands more for doing the same jobs.

Her colleague, Susan Mann, who works in cardiology, said: "It is just annoying that other trusts are paying grade four, but we are on grade three."

A spokesman for the Sunderland trust said a number of proposals were rejected by Unison during a meeting held at the Newcastle office of the arbitration service, Acas.

"Despite the trust going halfway to meet Unison's claim and, in addition offering a formal joint review of medical secretaries' roles, responsibilities and workload, they have declined to work with us on this basis," said the spokesman.

Members have also rejected the trust's suggestion of moving now to formal arbitration, where an independent third party - appointed by Acas - would make a final decision following representations by both sides.

The trust spokesman said efforts would be made to keep disruption to patients to a minimum.