Bosses at a Midland NHS Trust have unveiled plans of how they intend to select up to 800 staff for redundancy.
The heads of Sandwell and West Birmingham NHS Trust, which runs Sand-well and Birmingham's City hospitals, revealed the first 300 staff to go will be chosen by the end of the month.
Four wards, with a total of 90 beds, will also be shut down by that date - D12 and D28 at City and Newton 1 and Lyndon 4 at Sandwell.
The trust board also plans to make sweeping changes to gynaecology, paediatric, orthopaedic, stroke and respiratory departments to make them more efficient in a battle to save #20 million.
A selection process has been drawn up for compulsory redundancies.
Those who have served the least amount of time, perform badly, will not adapt to new duties, are bad time-keepers and have the least qualifications will be most likely to lose their jobs.
Plus and minus points will be given for everything from whether they have had warnings or disciplinary hearings to the speed they work. People with the most points will be safest.
Hospital chiefs are working with trade unions over the redundancies but said the 'last in, first out' criteria could affect many women and ethnic minority workers.
"It's a common principle, but may result in the loss of employees of value to the future of the organisation," said a spokesman. ..SUPL: