Efficiency savings within the NHS mean that almost 60 health administrators and managers face the axe in Durham, according to reports.
In addition to 110 jobs already planned to go, the County Durham and Darlington Trust announced there would be 58 further losses as it sought to save £4m before April 2011.
The BBC reported the trust launched a month-long consultation with the affected community health management workers, and will seek to achieve many of the job losses through voluntary redundancy.
The savings will be reinvested into frontline NHS care, said Tom Hunt, Chief Operating Officer for County Durham and Darlington Community Health Services.
He said: "We have now opened consultation with staff on proposed interim structures to reduce management costs and ensure the continued effective provision of community services.
"I am humbled by the dedication I see on a day-to-day basis from staff and am fully committed to keeping everyone informed throughout this difficult process."
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County Durham NHS