University Hospitals of North Midlands NHS Trust is planning up to 350 redundancies, including clinical posts, as it grapples with a financial deficit of £73 million. The trust has confirmed it is launching a time-limited voluntary redundancy scheme and pausing most new recruitment as financial pressure mounts heading into winter.

The trust runs Royal Stoke University Hospital in Stoke-on-Trent and County Hospital in Stafford, two of the main hospitals serving Staffordshire and the surrounding area. News of job losses on this scale, touching clinical roles as well as support posts, has alarmed staff and the union representing them, and raised fresh questions about how services will cope through the busiest months of the year.

Deficit grew from £60m to £73m in a week

The scale of the planned reduction has grown sharply in a short space of time. Unison, the public sector union, says the number of posts being considered for reduction rose from 225 to 350 within a week, while the deficit figure put to staff representatives climbed from £60 million to £73 million over the same period.

Regional officer Chanel Camilleri-Willis set out the union's concerns on BBC Radio Stoke, describing the process as rushed and warning that the speed of the change left little room for proper discussion of alternatives. The trust has not published a breakdown of which departments or grades would be affected, and it has not said how many of the 350 posts are currently vacant rather than held by staff.

Voluntary scheme and recruitment pause

Acting chief executive Helen Ashley said the trust was responding to what she described as significant financial pressures. The voluntary redundancy scheme will run for a limited window, with each application weighed against the needs of the service. Recruitment deemed essential to safe and effective patient care will continue, but most other hiring is on hold while the trust works through its recovery plan.

Voluntary schemes are the route most NHS trusts choose first because they avoid compulsory dismissals, but they carry their own risks. Staff who volunteer to leave are not always in the areas where the trust most needs to save money, and the trust has acknowledged that applications will be carefully considered against service needs before any are accepted.

Union warns clinical posts are at risk

Unison's sharpest concern is that clinical posts are included in the scheme at all. Camilleri-Willis called that really unusual and a massive concern, arguing that cutting frontline roles in a trust already under strain would add pressure on the staff who remain, many of whom she said were already burnt out.

The union has urged the trust to look harder at reducing its spending on agency staff before cutting permanent posts, saying the amount spent on agency cover is phenomenal. Agency workers cost trusts far more than employed staff for the same shifts, and unions across the NHS have long argued that reliance on agency cover is a false economy that should be tackled before permanent jobs are lost.

Wider pressure on NHS trusts

The trust faces a cost improvement requirement of more than £62 million for this financial year, alongside financial recovery expectations set nationally by NHS England. Those twin demands leave hospital boards with few levers, and voluntary redundancy schemes have become a standard response to financial pressure in English acute care.

Campaigners who follow the trust's performance share the unease. NHS improvement campaigner Ian Syme said he was deeply concerned about the voluntary redundancies and the pause on vacancies, while noting that the trust has severe performance issues that have already been cited by NHS England. He warned that patients could face longer waits for treatment and further delays to ambulance handovers, an issue that has already caused concern at Royal Stoke in recent months.

What happens next

The trust says patient safety and continuity of care remain its top priority, and it has stressed that essential recruitment will continue where patient safety requires it. The voluntary redundancy window is time-limited, and the position is likely to develop further in the coming weeks as applications are considered and the trust sets out which areas are affected.

For staff, the coming weeks will bring difficult choices about whether to apply, and for patients the test will be whether services hold up through winter with a smaller workforce. The trust has not said when it expects to confirm final numbers, and Unison is expected to keep pressing for a fuller account of how the 350 figure was reached and what alternatives were considered.