Norwich's main hospital is planning to cut �14m from its pay bill this year, as it seeks to save 8pc of its total budget.

The Royal College of Nursing (RCN), which released the figures, is warning that hospitals in Norfolk are planning to make cuts totalling more than �53m this year, with hospitals across the East planning to save a total of �231m.

The plans, known in the NHS as Cost Improvement Plans (CIP), come as the NHS as a whole has to save at least �20 billion by 2015.

The union says the most ambitious savings plan in monetary terms is that of the Norfolk and Norwich University Hospital, with �35m, or eight per cent, of its �447m budget to be saved.

The Department of Health asks NHS trusts to aim for four per cent savings in a year and Monitor asks NHS foundation trusts like the N&N to save between 4.5 and 5.25 per cent.

The CIPs show that cutting staff costs is a priority with �104m identified to be saved.

The N&N plans to reduce its pay budget by �14m, which include �4m on posts, �4.5m by meeting growing demand within existing staffing levels, �4m through keeping vacancies unfilled and managing the skill mix (for example changing higher pay grades for lower pay grades) and a further �1.5m on rostering-related initiatives.

The hospital hopes to make �6m of cuts elsewhere, for example by being more efficient, as well as increase its income by an ambitious �15m.

Regional director for RCN Eastern, Karen Webb, said 'We have consistently said to the NHS locally that we cannot support hospitals' plans for cuts without seeing those plans and understanding the rationale. The savings plans have, unfortunately, tended to be a closely guarded secret.

'Nurses and patients will be understandably nervous about the scope of these plans. In some cases these do look like heroic assumptions about saving millions but the cost to staff morale and to the quality of care for patients is a very high price to pay.'

The James Paget University Hospital in Gorleston did not reveal its plans for cuts to its pay bill, but is aiming to make �8m of savings, which represents 4.7pc of its revenue turnover.

The Royal College of Nursing's Frontline First campaign empowers nursing staff to speak out against the cuts that impact on patient care, expose where they see waste and highlight innovations and new ideas online at www.rcn.org.uk/frontlinefirst