An improved pay offer is being put to unions representing NHS workers on Wednesday, the Health Secretary has said.
Humza Yousaf and Deputy First Minister John Swinney are meeting health unions on Wednesday afternoon to discuss the fresh deal.
Speaking at an event to welcome more than 500 new staff into the Scottish Ambulance Service, Mr Yousaf said the offer is significantly improved on the 5% rejected by health and social care staff.
The Royal College of Nursing is balloting nurses on strike action for the first time in its history, while Unison is also balloting members across the NHS on strike action.
Mr Yousaf said it would be “catastrophic” if health workers downed tools as the NHS in Scotland gears up for a challenging winter.
He said: “Given the pressures of what we’re going to be facing this winter, having industrial action on top of that would be just devastating for the health service and for the outcomes of patients and our public as well.
“We’ll do everything we can in our gift to try to avoid that. I think the trade unions are negotiating in really good faith as well.
“The Deputy First Minister and I will be meeting with the trade unions and employers. They were pretty clear and unequivocal that their members rejected the historic 5% deal we offered last time round.
“It’s incumbent the Government have spent that time and come forward with a significantly improved offer.
“I will keep discussing it and stay up all hours of the night where necessary to get to an agreement.
“The last thing I want to see, and I believe the last thing the unions want to see, is industrial action at a time in our health service when we can’t afford it.”
Meanwhile, Mr Yousaf said the new ambulance staff will make a “significant difference” but the Scottish Government is still anticipating a challenging winter.
He said: “We’ve still got that pent-up demand from the two-and-a-half years of the pandemic. That’s not gone away. Because of the issues in social care recruitment we’ve got high levels of delayed discharge.
“All of that cumulative pressure means this could be one of the most, if not the most, challenging winter we have ever faced.
“I announced in Parliament £600 million of funding to help with our winter resilience overview, and that’s invested in different parts of health and social care services.
“A big key part of that plan was to recruit additional staff. But even with all that investment, which is important to do that, I still think it’s going to be a really challenging winter ahead.”