Nurses could be laid off to try to fill a £4 million health budget hole.

South Downs Health NHS Trust needs to find the savings to meet strict Government cost-cutting targets.

And bosses have admitted they are having to consider getting rid of dozens of staff including nurses.

Last night community leaders spoke of their concern that the trust could be forced to cut the posts.

Des Turner, the MP for Brighton Kemptown, said: "South Downs Health NHS Trust is a very small trust so for district nurses to be under threat is very worrying.

"I want to find out more about this as it is a serious matter of concern.

"District nurses provide an essential service. They are absolutely vital."

Brighton and Hove City Council leader Brian Oxley said he had first-hand experience with the local authority of having to cut costs with a minimal impact on the level of service provided.

He said: "I am sure this will be very worrying to the people who use the district nurses service.

"The council has close working relationships with partners in the health sector and this is an issue which we will watch closely."

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

Managers are halfway through an extensive review of its departments and services but it has emerged that 20 posts could be reduced in the district nursing department and is likely to affect both nursing and admin and support staff.

And 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.

The fears of job cuts come just days after The Argus revealed the NHS in Sussex had been underfunded by a massive £80 million during the last six years.

Brighton and Hove Primary Care Trust alone was given £52 million less during the last six years than it was suggested it needed by the NHS's own national funding formula.

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.

South Downs Health Unison rep Andrew Spencer said officers were keeping a close eye on developments.

He 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 is facing future changes because long term plans drawn up under the Fit for the Future public consultation are 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."