The trust said typing work was sent abroad as a trial

It follows a decision by the Royal Cornwall Hospitals Trust (RCHT) to send typing work abroad, while local workers are facing redundancies.

It comes two weeks after 400 workers were told that their jobs were at risk because of the trust's multi-million pound budget deficit.

The RCHT admitted it has made mistakes because of the speed at which "major changes" are being made.

Hundreds of Unison union members will be asked to vote on whether to start a campaign of industrial action.

They have misled the unions and totally betrayed their own staff Christine Dayus, Unison

A union spokesman said the trust had issued the letters while an outsourcing trial was carried out by the US-owned company Dictate IT.

It is thought the plans involved sending the work electronically to India.

Christine Dayus, the union's South West regional officer, said: "We have tried to work with the trust to minimise redundancies.

"However, we now find out that they are planning to send work abroad whilst making local staff redundant."

Ms Dayus claimed the work was substandard and said the trust had made no attempt to verify the quality of this work.

She said: "Serious errors relating to medication and treatment were made to patients' records and consultants had to spend hours making alterations in order to protect patient safety."

She said the union had no faith in the trust's current management to implement the savings plans required.

Three options

"They have misled the unions and totally betrayed their own staff," she said.

"We are more than willing to work with the trust to make changes but the implementation of this will endanger patient safety and is a complete betrayal of the Cornish workforce."

In a statement, the trust said the outsourced transcription service trial was one of three options being considered as part of a review of clinical administrative support.

It said it was going through a period of major change and the pace had led to some mistakes in the way it had handled some proposals.

The statement said the trust's situation meant changes had to be made, although no final decision has been made. It said unions would be invited to undertake a full and robust review of the pilot.