If public hospital nurses reject the latest pay offer from the DHBs, strike action will be the "next option", a union adviser says.

Public hospital nurses will consider strike action if they reject a new pay offer from the District Health Boards (DHBs), a union adviser says.

The New Zealand Nurses Organisation (NZNO), which represents 27,000 nurses, has been in mediation with the DHBs to negotiate an improved offer since January 31. The last agreement expired on August 1, 2017 and the DHBs' last offer was rejected in December.

On February 26 the DHBs returned with a revised offer, but stuck to the same annual percentage increases for salaries – a 2 per cent yearly increase for registered nurses, midwives, health care assistants and community nurses. Senior nurses and midwives would get a 4 per cent increase for 2017 and 2 per cent for 2018.

FAIRFAX AUSTRALIA The New Zealand Nurses Organisation (NZNO), which represents 27,000 nurses, has been in mediation with the DHBs to negotiate an improved offer since January 31.

Benefits of the new offer were a shorter two-year term, down from three years; an increased lump sum payment from $350 to $1050; and a commitment to a pay equity settlement on July 1, 2019.

READ MORE: * Public hospital nurses open to strike action after national pay deal rejected

If NZNO members vote for the deal, additional pay would be backdated to November 1.

Members have from Tuesday until March 23 to vote.

During the mediation period nurses presented a petition asking for "a better deal", signed by 15,000 members, to DHB chief executives

"Please keep our local health services safe and sustainable by delivering our nurses a better deal," the petition said.

"Their skills, hard work and compassion keep all New Zealanders happy, safe and healthy."

NZNO industrial adviser Lesley Harry said strike action would be the "next option" if members rejected the latest offer.

"We've negotiated all we can do and now the members have to make a decision."

She was uncertain how members would vote, but said the negotiating team did not believe it could have improved on the offer.

Contract negotiations began in July last year.

"There have been a number of presentations to the Ministry of Health and DHBs are just simply not able to offer an increase greater than the 2 per cent without additional funding – that's what they tell us anyway."

DHB chief executives met with the director general of health and Minister of Health David Clark three times, including after mediation, to discuss the offer, NZNO members were told.

Cabinet approved an amended position a week before the offer was made.

Harry said it was disappointing a better deal was not on the table, given Labour's promises to increase the health budget.

The union wanted to see funding for a pay equity settlement in Budget 2018 or 2019, she said.

Clark told Stuff it would not be appropriate to comment on Sunday, but told Nursing Review on January 24 that Labour recognised the need for a sustainably funded workforce, but "not all money pledged for healthcare would not all go into salary raises".

"Not everyone's expectations will be met. I think that is the reality and I think we need to be upfront about that," he told the industry magazine.

On the NZNO Facebook page members expressed their frustration about the offer and representation from the union.

"Why has an offer been bought (sic) back to us that doesn't reflect why we rejected the [first] offer? There are so many members feeling let down and annoyed."

Another member asked if the union would provide financial support for nurses who went on strike. They were told by NZNO there were no "strike funds" and members who chose to strike would have to forego pay.