The taxman says three and a half million people are due a refund, but two million will have to fork out for underpaid tax.
NHS regional pay plans condemned
Unison said NHS Trusts in the South West were considering making changes such as cutting pay and holiday entitlement
A group of NHS Trusts has been accused of undermining staff morale and patient care after details emerged of plans to introduce regional pay and conditions.
Unison said 20 Trusts in the South West which have formed a consortium to fix the pay, terms and conditions of health workers in the region were considering making changes such as cutting pay and holiday entitlement.
Proposals put forward included reducing sick pay, cutting the working week, equivalent to 250 jobs, and a 10% reduction in unsocial hours pay, said the union.
Tanya Palmer of Unison's South West region said: "The trade unions are well aware of the challenging financial times and the intense pressures on the NHS, but rogue employers involved in the consortium are risking the chance of reaching a national agreement.
"They are also undermining staff morale, stable industrial relations, staff recruitment and retention and, ultimately, patient care. The 20 NHS Trusts include Foundations from acute, teaching, mental health and community health care."
Ms Palmer said the consortium did not have the mandate, authority and responsibility to engage in negotiations: "Many Trusts in the South West are already struggling to recruit trained nurses, for instance Gloucester Foundation Trust and Royal Devon & Exeter Trust.
"Why should a nurse working for the NHS in Taunton earn less than a nurse in Birmingham? This will lead to a detrimental impact on patient care as staff move to better paid regions and morale plummets."
Unison said the proposals would be "extremely damaging" and would take staff in the South West out of the nationally negotiated Agenda for Change terms and conditions which cover 1.5 million health workers in England and Wales.
A Health Department spokesman said: "The NHS already has the freedom to determine pay terms and conditions, but most employers prefer national pay frameworks such as Agenda for Change. However, some NHS organisations are frustrated that trade unions have failed to reach agreement on proposals that NHS employers have put forward over the last 18 months to ensure Agenda for Change remains affordable and fit for purpose.
"Because of this, the South West consortium are in the early stage of open and transparent discussions with staff and local trade unions, but no formal proposals have yet been made. 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."
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