THE worst fears of hospital staff were realised yesterday as the scale of planned job cuts was spelt out by Oxfordshire health chiefs.

Nurses have been told that at least 225 of their posts are to go, raising the spectre of a deterioration in patient care at the county's main hospitals.

At a board meeting yesterday it was confirmed that a total of 600 jobs must go at the John Radcliffe Hospital, Churchill Hospital, Radcliffe Infirmary, Oxford, and the Horton in Banbury, representing the biggest number of losses so far in the South East.

Most of the 10,000-strong workforce are now being called to meetings to learn how services and departments will be hit, with potentially half of the redundancies being compulsory.

About 250 of the jobs to go will be managerial and administrative. A further 120 will be made up of health workers, including doctors, therapists and scientists. A 90-day consultation on the job losses has begun, with staff whose posts are at risk promised full support.

As part of the drastic cost-cutting programme to stave off debts of £33m, local hospitals will lose 130 beds: 60 at the John Radcliffe, 50 at the Churchill and 20 at the Horton.

Trevor Campbell Davis, chief executive of the Oxford Radcliffe Hospitals Trust, said: "Staff at risk of redundancy will be told during the next week.

"I would be surprised if half the redundancies are compulsory. We hope to make it less than that. We are not removing specific services. The pain has got to be widely spread across the trust. I understand that members of the public will say that you cannot make big changes like this without seeing a deterioration in service. Difficult changes do bring risks. But one thing I will not do is make changes that will impact upon patient safety."

The chief executive said efforts were being made to cut hospital workload by bringing down GP referrals. But he feared that waiting times for some operations could lengthen from four to five or six months, with more risk of delays for A&E patients waiting for beds. "When you have fewer beds, for whatever reason, it will hit patients coming in through the front door," he said.

Dawn Chambers, Royal College of Nursing officer in Oxfordshire, said: "We are very concerned that around 225 nursing posts will be lost. Whilst this will not necessarily be through compulsory redundancy, there will inevitably be a negative impact potentially on services and the workload and morale of those left behind.

"At the moment it is difficult to assess the impact that the changes will have on services, particularly at the Horton, though there will be a concern from staff and local residents about the future of the hospital as an acute provider."

Dr Beverly Malone, general secretary of the RCN, said: "These latest job losses in Oxford are just another sorry chapter in the on-going deficits saga taking place across England.

"We are seeing NHS services being eroded in a steady process of attrition. What is really worrying is that this is a trust that has already lost posts in the past two years."

One senior nurse at the JR, who asked not to be named, said: "We are seeing irreparable damage being done to the service.

"The changes are being executed by people who have little understanding about the clincial context. Some of them may not be here to see the consequences for patients, which will be profound.

"The good will that has energised the hospital for years, with people working extra hours and so on, is exhausted. The hospitals will be losing staff with a huge amount of experience, experience that simply cannot be replaced."

Oxfordshire's MPs were united in expressing concern about developments. Oxford East's Labour MP, Andrew Smith, said: "It is terrible that hospital staff are facing the prospect of redundancy. It's awful anxiety for people. The bottom line is that patient care must come first. Staff will be keeping me in touch about the impact, and in particular any threats to patient care, which I will raise at the highest level."

David Cameron and the county's three other Tory MPs sent a joint letter to the Prime Minister expressing anger about job losses that will result in "ward closures, delayed operations and lost beds across the county".

The letter says: "NHS staff should not pay for the Government's unfair funding system and nor should patients. Job losses will set back mental health services including Witney and Banbury, witness the loss of community hospital beds across South Oxfordshire, and leave the JR struggling to deliver operations.

"Oxfordshire now has fewer qualified nurses than we did four years ago. Our NHS must succeed, but Oxfordshire cannot if we lose the hard working, dedicated and experienced staff that are the foundation of a free health service."

Banbury MP Tony Baldry said the Government's audit figures showed Oxford Radcliffe NHS to be the most efficient hospital trust in England and Wales. He feared that the cuts would make the Horton unviable as a general hospital.

Dr Evan Harris, the Lib Dem MP for Oxford West and Abingdon, said: "I fear worse is to come".

Kelvin Aubrey for the health workers union, Unison, said: "It is unfair to place the ORH trust with those other trusts that the Government blames for the huge deficits."