NHS Direct staff are threatening industrial action over potential forced redundancies as part of the organisation's restructuring exercise, unions have warned.
Unison and the Royal College of Nursing (RCN) are both highly critical of the proposed cuts, highlighting the fact that NHS Direct is not in deficit but has to save £15 million from its budget.
As part of the proposals regarding the NHS, there would be a reduction in staff skill mix because the number of qualified nursing staff in front line services would fall from 66 per cent to 50 per cent.
A total of at least 573 redundancies could be made, including nurse advisor posts at axed call centres. At present, 12 NHS Direct centres could be closed, although a further 19 are under review.
Dave Prentis, general secretary of Unison, said that the proposals were a "recipe for disaster" and urged the government and NHS Direct to engage in discussions with unions to reach a solution.
"This cost cutting exercise at NHS Direct could put lives at risk and staff are so angry at the prospect, unions are gearing up for industrial action," he said.
"These proposals sacrifice quality for cost and the people who will suffer are the public in need of expert advice and reassurance. Hundreds of redundancies of staff and closure of call centres around England is not the way to make the service better."
Dr Beverly Malone, general secretary of the RCN, said that the proposals were another example of "inconsistency in the reform agenda with little thought for the consequences, where patients and staff will suffer".
Commenting on NHS Direct, she said: "This is a nurse-led success story, admired across the world, yet, we could see it dismantled with little thought or planning. NHS Direct staff morale is at rock bottom and they feel understandably angry and let down by their employer."
Shadow health secretary Andrew Lansley said that the proposed cuts were a result of the government's "mismanagement of the NHS".
"Many staff were employed at NHS Direct with a legitimate expectation that their skills would be used; now they face redundancy. It is a tragic waste of potential," he said.
"Clearly, we should redeploy staff who have acquired excellent skills for handling telephone advice into local out-of-hours and unscheduled care services."
A statement from NHS Direct said: "We realise that change is unsettling and are working to minimize the impact on our staff. We are listening very carefully to their views on how best to make these changes to improve our service.
"Consultation closes on 16th August. We will study carefully proposals from the unions, our staff and other parties in formulating the final changes to be implemented."
A Department of Health spokesman commented: "NHS Direct is not being dismantled, it is being improved… proposals for changing its organisation are about improving the service it provides to the public and making them more efficient."