At least 21,000 NHS staff at health trusts across England face redundancy by 2028 as employers struggle to balance their finances, according to new research.

Public services union Unison revealed its study estimates a minimum of 21,000 positions are set to be axed by 2028 across hospitals and other healthcare facilities.

Attempts to satisfy the Government's requirement for trust budgets to break even from this year are driving workforce reductions throughout hospital, community and mental health services, the union warned.

The cuts were uncovered by trusts responding to freedom of information requests submitted by Unison, and are on top of job losses at NHS England and integrated care boards announced last year, it cautioned.

The union said its research reveals trusts are planning cuts to roles including nurses and other clinical staff, as well as support post reductions through vacancy freezes, restructuring and reduced use of agency workers.

Unison's head of health Helga Pile said: "Cutting thousands of NHS jobs is the wrong answer when staff are already stretched to breaking point.

"The public are all too aware 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.

"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."

A Department of Health and Social Care spokesperson responded: "Thanks to the extra £26 billion we have invested, the NHS has an extra 12,000 doctors, 16,000 nurses, and 8,000 mental health workers compared to July 2024.

"We make no apology for reducing spend on agency staff, for which the NHS was previously paying huge sums to rip-off recruitment agencies.

"It is only because of that focus on getting better value for money that we have been able to invest in more frontline staff, give staff above forecast inflation pay rises for two years in a row, and improve services for patients."