Ambulance chiefs have pledged to continue providing a safe service should workers take part in a walkout over pay.
On Monday, the GMB Union launched a formal industrial action ballot among members from the East of England Ambulance Service Trust (EEAST).
The vote comes after a consultative ballot saw almost 86% of EEAST members say they were in favour of a walkout.
GMB has roughly 800 paramedics and ambulance workers from the trust who have voiced their frustration with the government's 4% pay award - with the union arguing it is a "massive real terms pay cut".
An East of England Ambulance Service spokesman said: “We are aware that GMB Union are undertaking a formal industrial action ballots across ambulance services in England.
“We will monitor the situation closely to ensure we continue to provide a safe service for our communities.”
Lola McEvoy, GMB Organiser, said: “GMB members in the ambulance service have been forced to take a stand in order to protect patient care.
“Dedicated ambulance workers are leaving trusts in droves, because the workload pressure is too much and the pay is too poor.
“Those left behind are fighting to protect themselves, their colleagues and the future of the NHS.
“They do not take industrial action lightly and haven’t gone on strike for 40 years – but things can’t go on like this; something has to give.”
Official ballot dates will be announced in the coming days.
On the announcement, Neill Moloney, Deputy Chief Executive of East Suffolk and North Essex NHS Foundation Trust - which runs Colchester and Ipswich hospitals and community services in east Suffolk and north Essex - said: “Our priority, as always, is to keep our patients safe.
"We will therefore work with our partners across the Integrated Care System to maintain safe staffing in our hospitals and services to mitigate the impact of any potential industrial action that may go ahead.”
GMB has also announced a formal strike ballot in Yorkshire, North East, West and East Midlands, North West and London Ambulance Services.
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