A group of NHS Trusts was today accused of undermining staff morale and patient care after details emerged of plans to introduce regional pay and conditions.
Unison said 20 Trusts in the South West which have formed a consortium to fix the pay, terms and conditions of health workers in the region were considering making changes such as cutting pay and holiday entitlement.
Proposals put forward included reducing sick pay, cutting the working week, equivalent to 250 jobs, and a 10 per cent reduction in unsocial hours pay, said the union.
Tanya Palmer of Unison's South West region said: "The trade unions are well aware of the challenging financial times and the intense pressures on the NHS, but rogue employers involved in the consortium are risking the chance of reaching a national agreement.
"They are also undermining staff morale, stable industrial relations, staff recruitment and retention and, ultimately, patient care.
"The 20 NHS Trusts include Foundations from acute, teaching, mental health and community health care."
Ms Palmer said the consortium did not have the mandate, authority and responsibility to engage in negotiations.
"Many Trusts in the South West are already struggling to recruit trained nurses, for instance Gloucester Foundation Trust and Royal Devon & Exeter Trust.
"Why should a nurse working for the NHS in Taunton earn less than a nurse in Birmingham? This will lead to a detrimental impact on patient care as staff move to better paid regions and morale plummets.
"The reality of these proposals are about pay cuts, 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."
Unison said the proposals would be "extremely damaging" and would take staff in the South West out of the nationally negotiated Agenda for Change terms and conditions which cover 1.5 million health workers in England and Wales.
Saffron Cordery, director of strategy at the Foundation Trust Network, said: "If national agreements were sufficiently flexible then foundation trusts (FTs) would continue to use them.
"There is much to be said for national frameworks with local flexibilities. But some FTs have found them too restrictive, and they have needed greater room to manoeuvre when responding to local conditions and the needs of their communities.
"We could well see more FTs developing local responses in future. These are cash-strapped times and trusts need to use their resources in the most effective way to improve the quality of care for patients and invest in its biggest asset - its workforce.
"A one-size-fits-all agreement is not always the way to achieve this."