Following a survey of trusts, integrated care boards and primary care in England, leaders called for an additional £6.4bn capital investment, commitment to fund the implementation of the long term workforce plan and a similar plan to be published for social care to ensure the NHS has the resources it needs.

Matthew Taylor, chief executive of the NHS Confederation said: ‘The NHS is operating under immense financial strain, with some local services already cutting or freezing clinical and managerial posts, as well as cutting some patient services. They are facing up to some drastic measures to balance their books this year.'

The NHS Confederation said trusts were ‘trapped in a cycle of short-termism where immediate cuts to meet financial targets are having to be prioritised over long term plans to improve and transform local services'.

Over two thirds (67%) of respondents planned to reduce clinical staff to meet their cost saving targets and 90% plan to reduce non-clinical staff too.

Similar figures were seen in primary care, with three quarters (74%) of leaders saying they will reduce clinical staff and almost 8 in 10 (79%) planning to cut non-clinical staff.

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UNISON head of health Helga Pile said: ‘No part of the NHS should be cutting staff when what's really needed is for many thousands of vacancies to be filled. False economies like these are foolhardy in the extreme.

‘There's little chance of reducing waiting lists and providing better patient care if staff numbers shrink any further.

‘Securing a decent pay deal after the election and stabilising the workforce are key to the future of the NHS.'

Liberal Democrat health and social care spokesperson Daisy Cooper said: ‘For far too long, first as chancellor and now as Prime Minister Rishi Sunak has let hospitals crumble and trusts cut vital staff just to balance the books.

‘Liberal Democrats would train, recruit and retain the doctors, nurses and other staff we need and fix our crumbling hospitals.'