Leading unions covering mid-Somerset health professionals have reacted with anger to the publication of a controversial new think-tank's ideas.
A consortium of 20 hospitals and health trusts have signed up to the South West Pay Terms and Conditions consortium, which will look at pay, overtime, holidays, incentives and working hours of the vast majority of NHS staff in the region.
The consortium, dubbed a cartel by unions, has been set up to look at solutions to the financial problems facing the NHS.
Discussion papers have now been published online, indicating how the group of NHS bosses may be able to deliver lower costs.
While the document stresses the list of almost 30 cost-cutting exercises are only ideas at this stage, the documents back up the arguments with lists of how much each would save a typical trust.
Ideas talked about include increasing working hours, decreasing holidays and restricting sickness pay.
Unions say that the changes would have a devastating impact on hospital staff.
A petition fighting the pay cuts has attracted thousands of signatures, and the move has been criticised by Labour and Liberal Democrat politicians.
UNISON South West regional manager Tanya Palmer said: "The employers involved in the consortium are undermining staff morale, stable industrial relations, staff recruitment and ultimately patient care.
"Many trusts in the South West are already struggling to recruit trained nurses, why should a nurse working for the NHS in Taunton earn less than a nurse in Birmingham?
"The consequences for the region will be disastrous, and will result in skilled health workers being driven out of the region, taking money out of the local economy and deepening the healthcare postcode lottery."
Representatives from the Royal College of Nursing say the changes will have a major impact on nursing standards.
One nurse, who works at the Bath Royal United Hospital but asked not to be named, said: "I just feel so disheartened. I love my job and I do all the shifts I'm asked to and then we get this."
A RUH spokesman said: "We are holding some briefing sessions to discuss our membership of the consortium.
"This is a regional steering group made up of representatives of 20 NHS trusts which has been established to address the serious financial and operational challenges facing the NHS.
"The group is responsible for identifying how public funds may be used more efficiently to protect employment, while continuing to deliver high-quality health care.
"At the meetings, we are also briefing staff on national proposals which could affect the Agenda for Change terms and conditions agreement."
Protests about the Consortium took place at Weston General Hospital. See page 36.