More than 6,000 NHS “jobs” in the South West could be saved if major changes go ahead to staff pay, and terms and conditions, it has been claimed.

The controversial South West Consortium of NHS trusts has published two “discussion” documents exploring the challenges it claims the NHS is facing and why action needs to be taken to address them.

As previously reported, the consortium – described as a “cartel” by unions – is considering breaking away from the national Agenda for Change framework.

The new documents are a clear move by the consortium to try and build a case for drawing up its own regional version of the pay framework, although it has stressed no decisions have yet been made.

Dorset Healthcare Foundation Trust has become the latest organisation to pay a £10,000 membership fee to join the group, taking the total number of NHS trusts involved to 20. Together, they employ 68,000 NHS staff across the South West.

Within the documents, the consortium claims a more “fit for purpose” system of pay and terms and conditions could safeguard more than 6,000 jobs in the region.

Some of the potential ways the consortium believes it could save money include reducing annual leave, changing consultant on-call supplements, adding extra working hours, reducing incremental pay, and reducing sick pay benefits.

The changes would be applied not just to staff on Agenda for Change but also to all grades of doctors, board directors, very senior managers, bank and agency staff and interim workers.

One of the documents states: “The alternative to addressing pay, terms and conditions is a wholesale reduction in headcount which, in potentially compromising minimum staffing levels and therefore patient safety, is extremely undesirable and costly.”

A full business case for the changes, which will also contain a series of recommendations, will be presented to each of the group’s trusts for discussion by their borads later this year.

The consortium has said it remains committed to national negotiations on changes to Agenda for Change. Unions, however, have accused the 20 trusts in the consortium of undermining those talks.

Christina McAnea, chair of the NHS staff-side council and Unison’s head of health, said: “This organisation has no status, or authority to enter into negotiations, and the trades unions will not be engaging with any proposals made by the cartel to cut pay, terms and conditions of our members.”

She warned the changes being mooted could harm, rather than help, the NHS in the South West, and also criticised the money trusts were spending on setting up the consortium.

“It beggars belief that at a time of financial constraint across the NHS, 20 trusts have ploughed £200,000 into a scheme whose only outcome will be to penalise hard-working staff,” she said. “This short term fix designed to address cost pressures is a negative move for employers, staff and patients.”

Poole Hospital Foundation Trust chief executive Chris Bown, who is chair of the consortium, said: “Consortium trusts are fully supportive of the national negotiations between employer representatives and unions.

“We believe we can and should work in the background as these discussions continue to give us the best opportunity to be sustainable organisations in the years ahead.”

But a Department of Health spokesman strongly hinted about a belief in the department that the cartel had come about because unions were dragging their heels in negotiations, saying that some NHS trusts were “frustrated” a national deal had not been reached on Agenda for Change proposals over the past 18 months.

“The need for local negotiations could be significantly reduced if the NHS staff council were able to bring national negotiations to a swift and successful conclusion,” he said.