Hospitals that fail to increase nurses' pay to reflect the 'true value' of their work could face targeted and disruptive strikes, a union has warned.

The Royal College of Nursing said it has entered into a landmark pay review with 'good grace' but its members are 'not afraid to strike' if managers fail to act fairly.

The Government announced in February that all 'band five' nurses in England would have their roles assessed and be moved to a higher pay band if their duties warrant it.

Professor Nicola Ranger, the general secretary and chief executive of the RCN, described the commitment as the 'best opportunity to elevate nursing in decades'.

A band five nurse is an entry-level role for newly qualified registered nurses under the NHS Agenda for Change pay system.

However, the RCN said some staff spend decades - and many their whole careers - at that banding, despite working at a higher level in terms of skills and responsibility.

A nurse currently starts on a salary of £32,000 compared with £41,000 for a resident - or junior - doctor in their first year of foundation training. Both can take home significantly more for working unsocial hours or overtime.

However, as many nurses fail to move off band five for life, it means their salary barely changes, while doctors see their pay rise rapidly as their career progresses, easily earning more than £100,000 a year by the time they become consultants.

Doctors have secured more generous pay rises than nurses in recent years after the militant British Medical Association repeatedly marched its members out on strike, forcing NHS bosses to cancel 1.5million appointments.

The Government will provide funding to employers to cover nurses' salary increases resulting from any re-banding but the union is still concerned some trusts will be reluctant to properly reward its members.

Professor Ranger said the RCN is waiting for the 'final plan' on how the scheme will be rolled out, but is expecting it in the coming weeks and hopes the process will start this summer.

She said the RCN will be 'absolutely clear and unapologetic' in holding employers to account, which could mean targeted strikes at 'outlier' NHS trusts.

'We expect our profession to be sitting at a band six,' Professor Ranger added.

'We know that those band five nurses that have been through a similar process in Scotland, 80 per cent of them have got up to a band six.

'Therefore, we have in our minds what that conversion rate should be.

'If we've got one trust getting 75 to 80 per cent of their nurses through, and another trust puts 5 per cent through, and we can start seeing the outliers, we will be absolutely clear and unapologetic in holding those employers to account.'

Being bumped up to a band six role would see nurses paid a basic salary of £39,959 to £48,117 before overtime and anti-social hours payments.

The top of the band five pay scale is currently £39,000.

Professor Ranger said: 'This is the best opportunity nursing has had for decades, because this money is not going to be coming from those organisations' budget, it is going to be coming from the Government.

'So, this is the first time that we can start to elevate nursing and it's not for the trust to worry where the money comes from, that's for the Government to agree and sort out, and it's for the trust to be fair to their nurses, simple as that.

'And we are going to be very bold and strong on that, and if they don't, we will take action against them.'

Professor Ranger said new Health Secretary James Murray has a 'tough challenge' ahead but 'will fail' if he does not value nursing.

A Department of Health and Social Care spokesperson said: 'Nurses are the backbone of our NHS and deserve to be properly recognised for the vital work they do.

'A nurse entering the profession today receives 18.6 per cent more in basic pay than four years ago, and this government has introduced a package of measures to transform the nursing profession and make sure nurses get the pay and support they deserve.'