Hundreds of health jobs are facing the axe because of falling patient numbers, health chiefs have revealed.
Darlington Memorial Hospital is one of the sites where jobs could go
County Durham and Darlington Acute Hospitals NHS Trust said up to 700 posts, including nurses, will go over the next three years.
The trust's chief executive John Saxby said demand for beds was falling because many patients were now being treated at home by community nurses.
North Tees and Hartlepool NHS Trust revealed 74 of its jobs were "at risk."
Mr Saxby said his trust was not in debt, but the imminent introduction of the NHS tariff would mean his hospitals would fall into debt if the job cuts did not go ahead.
This is because hospitals will receive funds on the basis of patients treated and less patients would mean less money for the trust.
He said: "Our waiting lists are plummeting and waiting times for patients are reducing dramatically and we are looking at workload and staffing and trying to balance them.
"So clearly, if doctors are sending less work to us then we are not getting as much money and we must balance the books somehow. "
The trust, which employs 6,000 workers, said 300 posts could go in the next 12 months and up to 400 over the following two years.
A spokesman said it was hoped this would be possible through "natural turnover" of staff and patient care "will not be affected".
The trust runs three main sites - the University Hospital of North Durham, Darlington Memorial Hospital and Bishop Auckland General Hospital. It also provides services from community hospitals.
North Tees and Hartlepool NHS Trust, which employs 4,500 workers, runs the University hospitals of North Tees and Hartlepool.
A spokeswoman for the trust said: "We have earmarked 74 posts for possible redundancy and have started consultations with staff.
"We have 90 fewer staff members on our books than we did last year through people leaving, so have already made significant inroads in staff reductions."
The Royal College of Nursing (RCN) said it was opposed to compulsory redundancies.
A spokeswoman said: "The loss of valuable, highly experienced frontline staff can only hit patient services and put even more pressure on the nurses and staff that are left."