The number of NHS job losses has doubled in the past year to more than 56,000, the Royal College of Nursing warns today.

The posts have already been axed – or are marked to be so – as the NHS struggles to find £20bn in efficiency savings. In the worst cases, some trusts are cutting up to a quarter of their workforce.

Dr Peter Carter, RCN's chief executive, said that 18 months ago there were fears about 5,000 NHS job cuts. "Now it is more than 10 times that figure."

David Stout, the deputy chief executive of NHS Confederation, said: "The NHS faces major challenges at the moment with growing demands for health services and no real increase in funding."