Nurses' morale has hit an "all-time low", health leaders have warned.

Many feel "personally attacked or punished" over the coalition's decision not to accept a pay review body (PRB) recommendation for a 1% increase for health staff, the Royal College of Nursing (RCN) said.

In a letter to MPs, RCN chief executive Dr Peter Carter said the decision could see many nurses leaving the profession.

"The morale of the nursing workforce is at an all-time low," he said.

"They feel they are being personally attacked or punished and many are viewing this refusal by the Government as the final straw and may leave the profession.

"We can ill afford a further exodus given the widely accepted workforce issues already facing the NHS and the difficulties trusts all across the UK are having in recruiting nurses to vacant posts.

"Failing to award a modest 1% cost-of-living increase to the workforce that has carried the NHS throughout huge reorganisation and large-scale workforce cuts will prove to be short-sighted and damaging to the NHS in the long run."

Yesterday the Government was warned it faces a summer and winter of industrial unrest because of growing anger over the pay of NHS workers.

The 1% will only be given to employees not entitled to an incremental pay increase, which Unison said will leave 70% of nurses facing a wage freeze this year.

The union's health executive has agreed to call for a ballot for industrial action when the issue is debated at Unison's health conference in Brighton later this month.