A struggling health board has been criticised after an official report revealed it is looking to shed 10% of its workforce.
NHS Tayside is aiming to shed around 1,300 members of staff as part of efforts to balance the books, through “natural staff turnover”.
It comes despite the Scottish Government pledging to write off millions of pounds in debt.
The plans are revealed in a section marked “other major issues” in an assurance report to the board from September.
It said there was an “acceptance that staff levels need to reduce by 10%”.
“It’s a recipe for disaster that could risk patient safety and staff well-being at NHS Tayside for many years to come.
“The financial chaos and risk that has plagued NHS Tayside is not the fault of its loyal and dedicated workforce, nor is it fair on the patients.
“For NHS Tayside to be considering cutting staffing by 10%, at a time when staff are already overworked and stressed, is unbelievable and raises serious safety concerns.”
NHS Tayside – which has a workforce of around 13,000 – has a projected deficit of £18.7 million for 2018/19.
It was among a number of health boards to have around £150 million worth of debt written off by the Scottish Government.
Several have received loans – known as brokerage – in recent years to fill funding gaps.
None of the job losses at NHS Tayside are to come through redundancies.
The reasoning behind the move was to bring its staffing level closer to that of other health bodies, it said.
Annie Ingram, NHS Tayside director of workforce, said: “Over the past two years, NHS Tayside has carried out a number of workforce benchmarking exercises which showed NHS Tayside’s spending on workforce is higher than similarly sized health boards.
“We spend around £540 million on staff every year and we have a responsibility to ensure that our public funding is spent in the best possible way.
“It is important that we identify where efficiencies can be made whilst ensuring that services are being delivered with the best use of the resources we are allocated.
“Patient safety and clinical care remain a top priority for NHS Tayside but we must also achieve financial balance.
“That is why we are carrying out an organisation-wide review of staff numbers, grades and skills, which is being carried out in partnership with our staff and our trades unions, to ensure we have a safe, affordable and sustainable workforce.
“Our transformation programme will present opportunities to redesign services delivering them in a different way with a different workforce.
“There is a no compulsory redundancy policy in NHS Scotland therefore no one will lose their job. Any reduction will be due to natural staff turnover.”
The health board had a new chief executive and chairman appointed in April.
A Scottish Government spokesman said: “It is right that NHS Tayside keeps its workforce under review – it is the responsibility of individual health boards to deliver good workforce planning, making sure that they have the right people with the right skills in the right place.”
He added that patient safety and quality of care are top priorities for the government, and said the health board’s resource budget has increased by 9% in real terms since 2010/11.