Trusts could be expected to protect frontline jobs and training as part of negotiating a public sector pay rise of just 1 per cent.

The proposal to offer job security in return for pay restraint is contained in the strategy NHS 2010-2015: from good to great. Preventative, people-centred and productive, which health secretary Andy Burnham launched last week.

This may require tough choices for staff, including working in a different place or in a different organisation

The Department of Health proposes to work with NHS Employers and trade unions to offer frontline staff “an employment guarantee locally or regionally in return for flexibility, mobility and sustained pay restraint”.

It says: “This may require tough choices for staff, including working in a different place or in a different organisation.”

At the launch, Mr Burnham said he did not think the financial pressures would mean mass redundancies of frontline staff.

Some organisations already have non-redundancy policies, such as University College London Hospitals Foundation Trust. HSJ understands a London-wide policy is also being worked up.

NHS Employers director Sian Thomas said employment guarantees were an option alongside partnership working and staff engagement.

She said it was “critical NHS leaders explore every alternative before making redundancies”.

A DH spokeswoman confirmed negotiations would be at a national level, but the actual job guarantees would apply within individual NHS regions.

The announcement followed last Wednesday’s pre-Budget report in which chancellor Alistair Darling said there would be a 1 per cent cap on public sector pay rises from 2011-12.

Unison senior national officer Mike Jackson said: “In the current climate job security is a big priority for our members.”

But he did not think accepting even a pay freeze would immunise the NHS from job cuts and said staff would need to be flexible about work roles. Negotiations would focus on the need to protect training, especially for redeployed staff, he said.