About 1,000 jobs could be lost at a Staffordshire hospital as managers try to reduce debts of £17m.
It is thought three quarters of the redundancies at the University Hospital of North Staffordshire in Stoke-on-Trent could be compulsory.
An estimated 370 of the posts will be nurses and midwives. Vacant posts may not be filled and 15 consultant posts could be cut.
A spokesman for the NHS trust said the hospital needed to reduce its workforce of 7,000 by the equivalent of 1,000 posts.
The hospital is inviting staff to consider applying for voluntary redundancy, early retirement or reduced working hours.
Chief executive Anthony Sumara said: “We hope once this most difficult part of the changes is completed the majority of staff who remain can begin to feel more secure and confident in the future.”
Last year the hospital’s trust chairman resigned over financial errors.