Unions at New Cross Hospital in Wolverhampton have said managers are in the “last chance saloon” after workers voted overwhelmingly to strike over job cuts.
Some 99% of workers who took part voted for industrial action, with 65% prepared to strike over 300 proposed job losses.
The trust is currently looking to save £8m through the cuts. It has overall debts of about £37m.
Peter Lowe, of Unison, told BBC News: “It’s the last chance saloon for the management to sit down with us and to avoid (us) taking action.
“What we are doing is giving the management every opportunity to avoid us taking this last dramatic action and we hope the management will listen.”
Managers have said they hope the job cuts can be made by natural wastage, but compulsory redundancies cannot be ruled out.
NHS trusts across the UK are making job cuts in a bid to tackle rising financial deficits.