More than eight out of 10 of staff working in strategic health authorities and primary care trusts are unsure about their employment future with the NHS

Almost 40% of the 400 respondents to the survey by believe they will be made redundant or lose their contract as a result of the white paper, Equity and Excellence: Liberating the NHS, and a further 46% do not know what will happen to them.

Many expect to know their fate within the next few months, due to demands for the health service to make £20 billion efficiency savings over the next four years having a further impact.

Three quarters of those completing the survey had worked for the NHS for more than five years, including a fifth who had worked for the health service for more than 20 years. Almost half were department heads or senior managers.

The vast majority of respondents (86%) said morale had deteriorated since the Government announced its plans to scrap commissioning bodies and transfer their functions to a new NHS Commissioning Board and GP commissioning consortia.

Of these, most (58%) said that morale had declined greatly and 18% reported that morale had fallen slightly. No respondent reported that it had increased significantly.

Jon Hoeksma, editor of eHealth Insider, said: “What is surprising is just how little confidence there is that the changes will be worth it, and how few people think the white paper will improve patient care. If there is a big idea behind these changes, the Government needs to spell it out and start working to take people with it.”

More than one in 10 respondents (13%) expected to be working for the private sector in healthcare, while 7% believed their future job would lie outside healthcare.

Asked to predict the impact of the white paper on colleagues, 47% thought many would lose their jobs and leave healthcare, while 25% believed colleagues would find new jobs in the health service.

NHS chief executive Sir David Nicholson has admitted that many NHS staff will find the latest round of reorganisation difficult and that a significant number will lose their jobs.

The day after the white paper was published, he promised that “every” member of staff working in an SHA or PCT would have the chance to discuss their future with a line manager by the end of September.