Paramedics in Lancashire have voted for industrial action over issues including cuts in ambulance cover.
A postal ballot carried out by the GMB union across the North West Ambulance Service showed 94 per cent were in favour.
The news comes at a time when the NWAS is under the cosh after crews failed to respond to several 999 calls including car crashes and fires in Lancashire.
The ballot had a turnout of almost 42 per cent and union officials say the first wave of action is now under consideration.
The GMB say the vote was taken after management refused the offer of talks on a number of issues including “cuts in ambulance cover, mileage allowances, subsistence allowances and staffing of vehicles by agreed clinicians.”
Paramedics say they are concerned that cuts have left the service unable to cope at peak times.
One car crash victim on a spinal board had to be transported to hospital in the back of a fire engine, as did two casualties from a house fire. Both cases were in Preston just a few days apart.