ONE of the region's largest NHS hospital trusts is looking to shed up to 700 jobs over the next three years.

The news that County Durham and Darlington Acute Hospitals NHS Trust is expecting to downsize was greeted with horror by trade unions yesterday.

Ian Daley, a regional officer with Unison, said: "This is going to send shockwaves through every workplace across the trust."

Local MPs, including former Health Secretary Alan Milburn, from Darlington, and Durham MP Roberta Blackman-Woods, expressed concern about the impact on constituents.

The County Durham and Darlington trust employs 6,000 people and runs Darlington Memorial Hospital, Bishop Auckland General Hospital, the University Hospital of North Durham, and Shotley Bridge Hospital, near Consett.

Yesterday, the North Tees and Hartlepool NHS Trust also revealed it is looking to lose 74 posts as part of cutbacks in addition to the 90 jobs that have gone at the trust this year.

The further losses add to the 237 NHS jobs that have been lost at the South Tees Hospitals NHS Trust, which runs James Cook University Hospital, in Middlesbrough, and the Friarage Hospital, in Northallerton, North Yorkshire.

The South Tees trust has slashed £30m from its budget this year and is aiming to finish the year with a deficit of £21m.

Bosses at North Tees and Hartlepool have also introduced across-the-board cuts and are expecting to finish the year £13.5m in the red.

News of the planned cuts at the County Durham and Darlington trust was leaked yesterday.

Spokesman Martin Hutchinson said the trust was not facing a deficit. He said: "We will break even financially this year. However, significant changes across the NHS mean that we may need to remove as many as 300 posts from our workforce of 6,000 in the next 12 months, and up to 400 over the following two years."

He said the reduction in posts should be possible "through natural turnover of staff" and hoped there would not be any need for redundancies.

Mr Hutchinson added that patient care would not be affected by the cuts because of changes in the way the NHS works.

The trust appears to be positioning itself for a new era in health care when increasing amounts of clinical work are carried out in patients' homes or at a local health centre by primary care staff.

The Government-backed shift away from the acute hospital sector will mean that resources will increasingly be spent on primary care provided by doctors, nurses and health care workers at local health centres.

Mr Milburn, who opened the Parkgate health centre in his Darlington constituency yesterday, said: "The hospital is looking at the issues they will face in the next few years.

"Waiting times have fallen very fast and they have done very well, but in the future more services will be provided in the community and that has an impact on hospital services."

Mr Milburn said he would be holding further talks with trust management and staff representatives.

Mr Daley, from Unison, said: "You can't lose 700 jobs and not affect the service to patients. It just isn't possible."

Elsewhere in the region, Selby and York Primary Care Trust (PCT) is facing a deficit of £23m, while the trust that runs Scarborough General Hospital is forecasting being £6.9m in the red.

In County Durham, Sedgefield PCT is heading for a £3.8m overspend, while Hartlepool PCT is looking at being £5.9m in deficit.

Yesterday, Chancellor Gordon Brown was forced to fend off accusations of ignoring the financial crisis gripping the NHS in his Budget.

The Tories claimed that 15,000 to 20,000 jobs across the country could be lost as hospital trusts tried to balance the books.

But Mr Brown said that only a small number of trusts were affected. He said that he had already made an additional £6bn available to the NHS this year - with a similar sum to follow next year - and it was now up to hospitals to bring their finances under control.

The row was triggered by the disclosure that London's Royal Free Hospital was shedding 480 jobs, only a day after Mr Brown delivered a Budget concentrating heavily on education but with comparatively little to say on the NHS.

Visiting a hospital in Wolverhampton, Tory leader David Cameron said that the cuts were a direct result of the Chancellor's failure to reform the NHS.

"Gordon Brown's failure was underlined yesterday by the Budget, which had nothing to say about the NHS despite cuts taking place right across the country," he said.