An NHS trust in Cornwall has been criticised for telling nurses to record the number of boxes of chocolates left for staff by grateful patients.
The Royal Cornwall Hospital NHS Trust announced 300 jobs are to go
Managers at the Royal Cornwall Hospital NHS Trust said they used the procedure, dubbed by staff as a "chocolate audit", to assess patient satisfaction.
The exercise was branded as "management madness" by health watchdogs.
The trust, which is facing debts of more than £8m, said it was not a compulsory audit for staff.
Figures for the trust, which is responsible for hospital sites at Treliske, Penzance and Hayle, showed that in 2005 there were 8,000 gestures of gratitude, including boxes of chocolates and thank-you cards and letters, compared with 316 letters of complaint for the year.
A spokesman said: "Like many hospitals, the trust informally records expressions of thanks as a small element of gauging levels of satisfaction.
"This is not a compulsory audit and records are not expected to be completed at the expense of time spent on patient care."
The trust announced in March that 300 jobs are to be axed due to a budget deficit of £8.1m.
The "chocolate audit" has also been criticised by health watchdogs.
Jono Broad, of the North Devon Patient and Public Involvement Forum, said: "It's sheer lunacy - management madness in the extreme.
"It's all because the rules say nurses cannot accept gifts from patients - even if it is just a box of Quality Street.
"They have to record how much the gift is worth and who it came from. Then the sweets are shoved into a cupboard."
A similar system is also used at Derriford Hospital in Plymouth.
A spokesman for Plymouth Hospitals NHS Trust said: "Our staff asked us to start measuring compliments as they wanted to have a record of more than just complaints.
"A number of our wards currently keep a record of the number of compliments - eg: cards, gifts and boxes of chocolates - they have been given by grateful patients and relatives."