Health Secretary Andrew Lansley revealed on Monday plans to abolish 152 trusts and ten strategic health bodies in England - which manage and pay for health services - as part of white paper proposals to cut management costs.

The 549 managerial and administrative staff of NHS Derbyshire County PCT, on Nightingale Close, Chesterfield, and 252 NHS East Midlands staff now face an uncertain future.

Martin Whittle, NHS Derbyshire County PCT corporate director, said: "We're very sad. The PCT has done a lot of work with health campaigns and they've been a success and we're in the top ten nationally after a commissioning assessment and we've a good record for managing finances.

"The changes put GPs in the driving seat but they'll need management support and we'll look at what might be offered to PCT staff, possible retirements, people choosing to leave and voluntary redundancies but nothing is confirmed.

"The view is to change the system and I think bringing GPs into the decision making process is good.

"There is a need to trim down management costs but we've made a £1.7m saving this year however these kind of savings are a fraction of what's needed."

Groups of GPs are preparing to take responsibility from PCTs for deciding what services should be made available.

Other proposals include moving hospitals out of the NHS to create social enterprises, GPs to work together in consortiums taking charge of a budget and hospital, mental health and community services.

The proposed structure aims to be overseen by an NHS board and public health campaigns will be passed to local authorities.