More than 300 NHS jobs are to be axed under plans by Brighton and Sussex University Hospitals Trust to save more than £10m over the next year.
The Royal Alexandra children's hospital is one of five affected
The job cuts - more than 7% of the trust's workforce - are likely to include redundancies, according to chief executive Peter Coles.
But he said natural turnover, early retirement and voluntary redundancy would account for the majority.
The trust, which runs five hospitals, has not said which jobs will be lost.
Secretarial and administrative staff are expected to be among those affected.
The trust runs the Royal Sussex County Hospital, Sussex Eye Hospital and the Royal Alexandra Hospital for Sick Children in Brighton and the Princess Royal Hospital and Hurstwood Park Neurosciences Centre in Haywards Heath, West Sussex.
It has a predicted year-end deficit of £11.3m, which makes a total shortfall of £21.3m when added to the £10m deficit from 2004/05.
Meetings to discuss the proposals with staff are being held this week.
The trust, which employs about 5,000 workers and has a £300m annual budget, is one of three in Sussex and Surrey to have a team of government troubleshooters sent in.
The turnaround team has been working for three months to find areas where efficiency can be improved.
They have included cutting the time people stay in hospital and boosting the number of patients undergoing day surgery.
In a statement on Wednesday, Mr Coles said it had not been possible to save enough through efficiencies.
"Action has already been taken to reduce our deficit but we recognise we still have a long way to go," he said.
"Providing high quality patient care remains our top priority and in changing the way we work we will ensure that our services remain patient-focused.
"However...some difficult decisions need to be made.
"This does not mean that 325 staff will lose their jobs.
"The trust has a staffing turnover of more than 12% a year and this, together with staff vacancies and a high use of bank and agency staff, will give us many opportunities to reduce staff numbers without making staff redundant."
He said the first option would be to redeploy and retrain staff.
More than 4,000 job losses have been announced across England in the last few weeks as hospitals attempt to balance their books.