Jobs are set to go at Plymouth's Derriford Hospital as health bosses try to tackle a near £6m deficit.
Hospital bosses are aiming to make £7m in savings
A review of jobs is one option hospital managers are considering to reduce the overall pay budget by about 5%, saving £7m.
The number of job losses, and the posts which will be affected, has not yet been decided.
The hospital is also hoping to save money by introducing better working practices.
The Plymouth Hospitals NHS Trust, which runs the hospital, said the review was being carried out because of growing financial pressures.
The Trust said it wanted to concentrate resources on improving and maintaining patient care and it was looking at more cost effective ways of doing that.
Areas it was looking at included on-call and overtime expenditure.
Trust chief executive Paul Roberts said posts would be lost in future phases of the review, but it was currently unclear how many or in which area of the hospital's work.
The Trust stressed that staff numbers had increased greatly in the past few years, with 6,200 employees in March 2003, compared to 5,200 in March 2000.