Derriford Hospital is facing a �25m overspend this year

The hospital, which has 3,145 nurses and midwives, said there would be some compulsory redundancies, but most jobs would go by not filling vacancies.

The biggest hospital in the South West, which is facing a �25m deficit this year, is also planning to cut 50 beds.

Hospital managers said that more day cases meant fewer patients need to stay in overnight.

Plymouth Hospitals NHS Trust said the hospital had already stopped using agency nurses which had saved �4.6m.

Balance budget

It had also introduced an almost total freeze on vacancies unless exceptional circumstances applied.

Spokeswoman Christine Lloyd-Jennings, said: "The NHS as a whole and this Trust is receiving greater investment, without which we could not expand.

"In the last five years we have doubled our consultant numbers and recruited more than 600 additional nurses and midwives.

"But the levels of new investment are not enough to fund everything we need to do and so we have to look at the way we work and part of that process is looking at the way we employ staff and the work they do.

"We have to balance our budget and make sure that we are as efficient as possible and that the money we do have available is concentrated on direct patient care."