A survey of more than 1,000 health workers in the South West has revealed that 97% are deeply worried about proposals to establish a regional pay cartel in the NHS.
Researchers for Unison found some key workers voicing concerns that a reduction in pay and conditions would leave them without enough money to put food on the table.
The 20 health trusts which have signed up to the South West Pay Consortium, including hospitals in Truro, Plymouth and Exeter, say they are trying to find ways of meeting unprecedented financial challenges.
But unions will today meet MPs from the region to express their firm opposition to the group.
In a response to the survey, one nurse summed up the feelings of many: "Already we are pushed to the limit and beyond to maintain a service.
"We provide most of the care for patients and are poorly rewarded for this. I am getting poorer by the year, and also have to pay to park in an empty hospital car park at night.
"I live on a single income so expenses are harder and harder to manage.
"Loyalty, commitment, hard work mean nothing. Morale is bad enough without any more pressure."
Christina McAnea, Unison head of health, warned the SWC there would be serious consequences.
"The top-quality patient care that people in the South West need and deserve depends on top-quality staff," she said.
"We know that health staff across the country are under incredible pressure.
"This survey shows that the South West pay cartel's plans could push health workers in the region to breaking point.
"Some of the responses to our survey were heartbreaking. Health workers are worried for themselves – their mental health, their finances.
"They are worried about the impact on their families, but also what these changes would mean for their patients.
"In our briefing with MPs we will be warning that these plans not only contain risks to the smooth delivery of services to patients, but are also deeply unpopular politically.
"We will be urging them to put pressure on the trusts in their areas to put a stop to these damaging plans."
Recently released discussion documents from the SWC emphasise that "absolutely no proposals have been put forward regarding any proposed changes to pay, terms and conditions".
However, they go on to detail a number of "staff cost reduction potential opportunities" including asking people to work extra hours for no extra pay, reducing unsocial hours allowances and reducing sick pay for new starters.
A spokesman said: "The consortium is currently looking at ways in which amendments to pay, terms and conditions might support member trusts in maintaining financial health and organisational stability, now and in the years ahead, in the face of unprecedented operational and financial challenges.
"As significant employers and service providers, we believe we have a responsibility to look at how we most efficiently use our largest outgoing – pay – to support sustainable organisations, prioritising job security and viable, high-quality services over any need to make redundancies to meet these challenges.
"It is also important to note that the consortium is also considering areas in which staff may clearly benefit, for example by making investments in education and training, and ways in which high performers might be rewarded, beyond that which is currently possible."
