AT LEAST 21,000 NHS roles in hospitals and other health facilities across England are set to be cut by 2028, according to a major Unison study.
The report, combining Freedom of Information requests to more than 200 NHS trusts with published accounts and NHS England financial data, revealed that NHS providers hit a combined deficit of more than 1.1 billion GBP in 2025.
This wave of NHS posts to be axed follows major job losses at NHS England and integrated care boards announced last year, the union reported.
Helga Pile, head of health, Unison, London, UK, said: “Cutting thousands of NHS jobs is the wrong answer when staff are already stretched to breaking point.
“The public are all too aware of how understaffing is a major problem, so they’ll be rightly alarmed when the situation’s getting worse.
“Years of underfunding have left many trusts out of pocket and ministers’ financial reset is creating deep uncertainty about services and staff.
“Morale is through the floor as workers worry whether their jobs are at risk, amid soaring levels of stress and violence.”
Research revealed that NHS trusts are planning cuts to at least 3,600 clinical roles as well as support post reductions through vacancy freezes, restructuring, and reduced use of agency workers.
Some of the largest planned job cuts include those at University Hospitals Sussex NHS Foundation Trust, which is set to terminate more than 1,500 funded posts.
Both Blackpool Teaching Hospitals NHS Foundation Trust and Frimley Health NHS Foundation Trust are planning to axe around 1,200 jobs.
Growing Financial Strain
This comes amid a significant funding crisis and mounting financial pressures, the union said.
East Lancashire Hospitals NHS Trust reported a deficit of more than 47 million GBP in 2024/25.
Barking, Havering and Redbridge University Hospitals NHS Trust experienced a shortfall of nearly 39 million GBP.
Pile continued: “The NHS is being asked to transform how care is delivered, with more community services and technology.
“But none of this is possible without the staff to make it happen.”
The union is calling for the government to review the impact of break-even financial rules on staffing and services, to ensure that NHS organisations are supported to expand workforces to meet demand, rather than cut them.
Reference
UNISON. Less fit for the future: workforce cuts put patient care, staff and NHS reform at risk. 2026. Available at: https://www.unison.org.uk/content/uploads/2026/04/UNISON-2026-Health-FOI-Survey.pdf. Last accessed: 14 April 2026.
Featured image: chrisdorney on Adobe Stock
