Up to 1,600 jobs are to go at an NHS trust in the West Midlands.
The Heart of England NHS Trust, which covers East Birmingham, Solihull and south Staffordshire is to shed the jobs over the next four years.
Chief executive Mark Newbold said the trust was used to making savings of up to 5% per year.
He said 400 staff equated to 4% of the trust’s staff base and he anticipated the cuts could be made without enforced redundancies.
“We are used to making savings of between 3 to 5% a year,” he said.
“So 400 staff is roughly 4% of our staff base.
“We turnover about 600 staff a year so its very manageable without, for instance, enforced redundancies.”
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