Almost half a million health workers accepted a pay deal on Friday, bringing relief from ministers and almost certainly averting another bitter public sector wages row.
Almost two-thirds of members from Unison, accepted the government's three-year offer, which the union had said was worth a total of 8.1 percent.
The acceptance of the deal, from 64.91 per cent of members, will see workers get an extra 2.75 percent this year, a 2.4 percent rise in 2009 and 2.25 percent increase in 2010, officials said.
While some smaller unions have already rejected the pay deal, the Royal College of Nursing (RCN), the second largest union in the NHS, has also backed it.
The government hailed the result as great news for NHS staff and a fair deal for workers.
The move has almost certainly averted an ugly pay dispute for the government and helped Prime Minister Gordon Brown avoid another political headache, after battles with other public sector workers over wage conditions in recent months.
Unison officials will meet with chiefs of smaller unions next week to try to bring them on board, with a sign off expected shortly afterwards.
Before voting, Unison leaders had made no recommendation as to whether or not their members should accept the deal.
"Unison gave all our health members the opportunity to make their vote count and the ballot result shows what a tough decision it has been," the union's head of health, Karen Jennings, said in a statement.
Because of the rising costs of food, fuel and energy, she said the union had a "reoponer clause that we will not hesitate to trigger if inflation continues to rise".
Dr Peter Carter, the RCN's chief executive and general secretary, said his union was "delighted" with the deal.
The decision comes as the National Health Service said it was forecasting a surplus of almost 1.7 billion pounds for its 2007/08 financial year, equivalent to around two percent of its overall budget.
The NHS returned to overall surplus last year after two years of deficits that saw a jobs freeze, wards closed and non-urgent operations delayed at many hospitals.
Many other public sector workers have already taken industrial action or are holding strike ballots over the latest pay offers from the government, putting pressure on Brown as his popularity in polls crumbles.
In April, about 100,000 workers from teachers to job centre staff and coastguards went on strike over pay deals which they said failed to match inflation.
About 800,000 council workers from Unison are currently voting on whether to turn down their pay award, with the union recommending strike action.
Of the NHS deal, health secretary Alan Johnson said: "The outcome is a fair settlement that will help those on the lowest wages, increase the earning potential for hundreds of thousands of staff and allow them to climb the pay ladder more quickly."
