More Than 20,000 NHS Jobs Set to Be Cut as £1.1bn Deficit Forces Trusts Into Crisis

LONDON April 13: Thousands of National Health Service staff across England are facing redundancy as financially strained health trusts move to slash costs in a bid to balance their budgets, according to new findings published yesterday.

Research by the public service union UNISON reveals that at least 21,000 NHS roles are expected to be cut by 2028, as hospitals and other healthcare providers grapple with a combined deficit exceeding £1.1 billion.

The figures, drawn from a large-scale data-gathering exercise based on Freedom of Information requests, paint a stark picture of an overstretched health system under mounting financial pressure. The union’s report, Less Fit for the Future, highlights how government demands for NHS trusts to break even financially from this year are accelerating widespread job reductions across hospital, community, and mental health services.

These newly identified cuts come on top of previously announced job losses within NHS England and integrated care boards, suggesting the scale of workforce reduction is significantly greater than first thought.

Among the roles at risk are at least 3,600 clinical positions, including nurses and frontline healthcare staff. However, many trusts have yet to specify exactly where cuts will fall, raising concerns about the potential impact on patient care. In addition to direct redundancies, trusts are also reducing staff numbers through hiring freezes, restructuring programmes, and limiting the use of agency workers.

Some of the most significant workforce reductions are planned at major trusts. University Hospitals Sussex NHS Foundation Trust intends to cut more than 1,500 funded posts, while both Blackpool Teaching Hospitals NHS Foundation Trust and Frimley Health NHS Foundation Trust are each preparing to eliminate around 1,200 roles.

The cuts are unfolding against a backdrop of severe financial strain. East Lancashire Hospitals NHS Trust reported a deficit of over £47 million for the 2024/25 financial year, while Barking, Havering and Redbridge University Hospitals NHS Trust faces a shortfall of nearly £39 million.

Several trusts have already warned they may be unable to achieve financial balance even within the government’s timeframe. Hull University Teaching Hospitals NHS Trust, for instance, has projected deficits of £50.2 million and £46.2 million in 2026/27 and 2027/28 respectively, and may require additional central support.

Despite these challenges, new government measures impose financial penalties on trusts that fail to break even—an approach UNISON argues risks deepening the crisis rather than resolving it.

The union cautions that the true scale of job losses could be considerably higher, as not all NHS organisations were able to provide complete workforce data.

Separate survey findings from nearly 20,000 NHS staff suggest the impact of financial pressures is already being felt on the frontline. Around 65% of respondents reported increased workloads following job cuts, while the same proportion said their stress levels had risen. Nearly half (47%) said internal systems had slowed due to staffing shortages, and 42% believed patient care had deteriorated.

UNISON warns that the NHS is entering a “doom loop,” where rising workloads lead to burnout and sickness, prompting further staff departures and placing even greater strain on remaining workers.

The union is urging the government to reconsider strict break-even requirements and instead prioritise investment in staffing levels to meet growing demand for healthcare services.

Helga Pile, UNISON’s head of health, said cutting jobs at a time of acute staffing shortages risks worsening an already fragile system.

“Cutting thousands of NHS jobs is the wrong answer when staff are already stretched to breaking point,” she said. “The public know understaffing is a major issue, and they will be deeply concerned to see the situation deteriorating further.

“Years of underfunding have left many trusts in financial difficulty, and the current financial reset is creating uncertainty for both services and staff. Morale is extremely low, with workers facing rising stress and concerns about job security.

“The NHS is expected to transform how care is delivered, with greater emphasis on community services and new technology. But without sufficient staff, those ambitions simply cannot be realised.”