An exodus of nurses out of the South West is creating a "fragile landscape" which will only worsen if controversial plans for a regional pay cartel go ahead, a union has warned.
A study by the Royal College of Nurses (RCN) has revealed that the region has seen the highest drop in nurses of anywhere in the country since the Coalition came into power.
And it warns that 750 jobs are already planned to be cut across Taunton, Cornwall and Exeter over the next three years.
The report claims the Westcountry is already under strain because it has the oldest population in England and an already pressurised workforce.
And it says money-saving plans by a coalition of 20 South West health trusts to change the conditions and pay of all workers in a bid to save cash will threaten the care of some of the region's most vulnerable patients.
Today RCN chief executive and general secretary Dr Peter Carter has written to all the trusts involved, urging them to ditch the cartel and explore other solutions to save money.
He called the measures "draconian", and said: "There is a demoralised workforce under huge pressure to help some of the UK's most vulnerable patients. This is an increasingly fragile health landscape which requires long-term solutions looking at service redesign rather than simple cost-cutting."
The RCN is the latest in a string of unions to lambast the plans. Unison has organised a series of protests, and the British Medical Association has refused to recognise the cartel.
Each trust has paid £10,000 to sign up to explore the option of changing terms and conditions, amid tough financial challenges at a time when the NHS has been tasked with saving £20 billion.
But the RCN findings reveal the already "precarious" state of health care in the South West, where nearly 20% of the region's population is aged over 65, compared to a national average of just over 16%. The region also has fewer qualified nursing staff, and the highest number to leave the region of anywhere in the country since the Coalition came to power, at 3.5 % compared to national average of 1.6%.
But the South West Pay Terms and Conditions consortium, as the pay cartel is offically known, has insisted that the move will protect jobs, a claim the RCN says is "simply not true".
Steering group chairman Chris Brown said: "By promoting financially healthy NHS organisations, we can preserve employment and reduce the need for redundancies.
"Our analysis shows that up to 6,000 NHS jobs in the South West may be safeguarded by changes to staff pay, terms and conditions."