Up to 20 jobs are to be axed in the district nursing service under NHS plans to make savings of £4 million.

Nurses and support staff face the threat of redundancy under South Downs Health NHS Trust's review.

Andrew Spencer, of the Unison public sector union, said: "Obviously people are very concerned. We know 20 posts are at risk in the district nursing area but we don't know what is happening elsewhere at the moment.

"We will have a better idea in a few weeks times when the results of the reviews in other departments come in.

"Some people are obviously angry and worried and others also realise that the trust is being forced into this because of the rules about making the savings.

"It is odd that in a time when there are moves to provide more services in the community, money is being taken away.

"We are doing everything we can to ensure redundancies are a very, very last resort."

The trust provides community and rehabilitation facilities mainly in the Brighton and Hove area and employs around 1,500 people.

Managers are halfway through the review but it has emerged that 20 posts could be reduced in the district nursing department.

Chief executive John O'Sullivan said it was too early to say whether posts would be lost in other parts of the trust but admitted it could not be ruled out.

Other areas being reviewed include intermediate care, occupational therapy, speech and language and non-clinical support services.

The district nursing team, which has 120 posts and more than 200 full and part time staff, is the largest at the trust.

The trust's beds for elderly patients at Newhaven, its Chailey Heritage site near Lewes for children with disabilities and learning difficulties and its stroke rehabilitation service at Shoreham are not part of the review.

All NHS organisations are required by the government to make efficiency savings of three per cent every year.

Bosses at South Downs, which has an annual budget of around £70 million, have calculated that £4 million needs to be saved by 2010.

Managers have been studying each department to see how they can be run more efficiently while maximising the time staff spend with patients.

Everything from the time spent on compulsory training and how it is done, to the use of mobile technology and scheduling work to reduce travel time is being investigated.

Trust bosses are hoping to minimise redundancies by offering staff alternative posts elsewhere within the organisation and not filling current vacancies.

The trust is facing future changes as long term plans drawn up under the Fit for the Future public consultation which is expected to lead to more services being provided in the community rather than hospital.

Mr O'Sullivan said: "We have to be competitive and focus on quality while finding ways of doing things that make us more efficient.

"We have a huge amount of experience behind us and will use that to change and develop for the future."

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