Dr Gill Morgan, chief executive of the NHS Confederation, which represents over 90 per cent of NHS organisations, said:

"Some hospitals have had to make very difficult decisions in recent weeks and unfortunately some job losses have been necessary. It is possible that there will be more job losses announced in the NHS, but the actual figures cannot be calculated in such a simplistic way as there are many reasons for the cuts. It is spurious to take data from a few trusts and extrapolate national figures.

"Whilst some job losses have been necessary in order to balance the books in financially challenging times, in other cases hospitals have been looking at how they can work more productively by changing the way they organise and run services.

"This may mean providing more care outside of hospitals in the community and therefore reducing the number of beds and wards in hospitals themselves. Or using new and better technologies to treat patients more effectively. Both will have implications for the numbers of staff that we need to employ.

"For patients that are treated in hospitals, reducing the amount of days that they spend on the ward is both good for them because they recuperate quicker at home but also means that bed, ward and staff numbers can be reduced.

"Introducing digital x-ray facilities, robotic pharmacists or applying lean manufacturing techniques to pathology services all save money and provide a more efficient service to patients.

"The NHS is castigated for not being productive and then castigated again when it takes action to improve productivity."

Steve Barnett, Director of NHS Employers which is part of the NHS Confederation, said:

"Spending on workforce makes up the largest part of trust budgets and employers will be looking critically at staffing as a way of managing deficits and improving productivity.

"The picture varies considerably across the country as employers decide locally how best to manage their staffing needs. Where they choose to reduce their workforce numbers, this doesn't necessarily mean redundancies. Many will leave posts vacant when people leave, reduce numbers of temporary staff or re-deploy staff to other trusts rather than making valued members of staff redundant."

The NHS Confederation represents more than 90 per cent of the organisations that make up the NHS. Its members include the majority of NHS acute trusts, ambulance trusts, foundation trusts, mental health trusts, primary care trusts, special health authorities and strategic health authorities in England; trusts and local health boards in Wales; and health and social service trusts and boards in Northern Ireland.

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