The majority of UK managers think work pressures have increased as a result of the economic crisis, according to a study.
The findings come as ministers warn NHS services in some areas could soon be inundated after reports from GPs show more and more ex-private patients are using community surgeries.
The study, by research group Roffey Park, found three out of five managers believed the state of the economy had impacted negatively on their organisation.
An NHS Confederation spokesman said the service was steeling itself for a further surge of patients as the recession looms ever closer.
But the survey of 850 managers found that, despite the turbulent financial climate, the number of organisations planning job cuts had actually fallen from over a third to one in four.
Jo Hennessy, director of research at Roffey Park, said: "Managers are increasingly aware of cost spending restrictions in reaction to the economic downturn.
"Even those who do not report any impact as yet on their businesses are looking to cut costs. It's this, and the uncertainty in the workplace, which makes it difficult for managers to motivate and develop staff."