The Government's promise to protect the NHS from cuts is an "urban myth", a union has warned as it released figures showing almost 27,000 posts face the axe.
The Royal College of Nursing (RCN) said waiting lists for operations will rise as job losses mount and the public "should be really concerned" about the impact of the cuts.
Dr Peter Carter, chief executive of the RCN, said job losses sre occurring by "stealth", with trusts withholding evidence of redundancies and recruitment freezes. And he declined to rule out the chance of another scandal such as that which occurred at Stafford Hospital, which was partly blamed on low staff numbers.
Some 26,841 posts have either gone in the UK health service or are earmarked for closure, according to figures collated by the RCN, with the posts lost either through redundancy, recruitment freezes, jobs being downgraded or people not being replaced when they leave or retire.
A huge range of NHS services will be impacted by the cuts despite the Government saying health service spending is ring-fenced, said Dr Carter.
"This is set against the urban myth that the NHS is being protected," he said. "The evidence we have gathered is quite clear: that is not the case."
He added: "Right now, staff are not only concerned about losing their jobs, they are concerned about keeping services open and how they will cope if they stay. The mood at the moment suggests that it is two minutes to midnight for the NHS, and action to avert a crisis is needed now."
But NHS chief executive Sir David Nicholson said: "The accuracy of these figures is not guaranteed and we do not recognise their figure. While it is for local trusts to determine their specific workforce needs, we have made it clear that efficiency savings must not impact adversely on patient care, and that every penny saved must be reinvested in support of frontline services and improving quality.
"The Government is committed to the NHS - to sustain and to improve services in the face of a tough economic climate - and that is why the NHS received a real terms increase in funding. But even with this commitment, in order to meet demand and improve the quality of services, the NHS needs to make up to £20 billion of efficiency savings by 2015."