A £2bn pot being put aside by NHS trusts could be used for redundancy pay-offs as job cuts are made, a union has warned.
Unison claims that guidance in the NHS operating framework for 2010/11, which orders trusts to save 2% of their budget for one-off commitments, would effectively be used to sack staff.
General Secretary Dave Prentis (pictured) said: "Make no mistake, cutting costs and sacking NHS workers will see the quality of patient care fall. Nurses, midwives and healthcare assistants work as part of a team. They depend on other staff for support so they can do their jobs."
Officials from the Royal College of Nursing (RCN) warned last month that a need to find up to £20bn of "efficiency savings" in the next three years meant that thousands of jobs would be axed.
The RCN said, based on data from 26 trusts, about 5,600 posts were at risk but a worst-case scenario could see more than 36,000 NHS staff lose their jobs.
Health Secretary Andrew Lansley said: "Efficiency savings are being made in order to improve NHS care. I have been clear that this money will be reinvested into NHS services."
Trusts that manage to save the 2% figure can decide on how it is spent. Redundancies and retraining of staff are two of the options available.