A mental health trust, which has been criticised for job and bed cuts, may reduce workforce numbers by another 200 over the next five years, a new report has warned.

Campaigners have pledged to lobby Norfolk and Suffolk NHS Foundation Trust's (NSFT) board of directors meeting today over a new plan, which says that extra savings of £44m would need to be found by 2019, if there is no major increase in mental health funding.

The NHS trust has reduced staffing numbers from 3,941 to 3,500 as part of a radical redesign of services to reduce its budget by 20pc by 2016. However, a draft strategic plan for 2014-2019 warns that the staff headcount could be brought down to 3,300 in a bid to find further savings.

Directors at NSFT will discuss the five year plan at a meeting in Swaffham today, with officials warning that the mental health trust will receive no increase in funding from Clinical Commission Groups and predictions that mental health referrals in Norfolk and Suffolk will continue to rise by 4pc year-on-year.

A report by Leigh Howlett, commercial director, said the four CCGs in Norfolk only spent 9pc of their total budgets on mental health and the trust was likely to lose 1.8pc on its four main contracts, despite an increase in demand and growing population.

She added that under current projections, NSFT would need to find 'cost improvements' of £44.1m by 2019 to balance its books.

The report said: 'Given that the majority of the trust's cost base is pay related then it has been assumed that for the purpose of planning a large proportion (64pc) of the total £44.1m will be identified through pay savings. To date these type of efficiencies have been achieved through service redesign, corporate restructuring and reduction in temporary pay costs.'

'For the purpose of this plan an assumption has had to be made that there will be continuing reductions in headcounts in order to achieve these targets, reducing from 3,500 to 3,300 between 2015/16 and 2018/19. It is the view of the trust that in addition to any internal cost savings opportunities that may be identified going forward that a significant proportion of the £44.1m will need to be met from external system reviews or structural changes within the local health economy.'

The five year plan adds that NSFT has a 'significant' estate portfolio of more than 130 buildings and the NHS trust will look to sell property deemed to be not fit for purpose or no longer required over the next two years, which could free up almost £10m in capital. The strategy also aims to end all non specialist out of area bed placements by March 2015.

Michael Scott, chief executive of NSFT, said: 'There is a national requirement for our trust to plan for the next five years on the

basis of an annual 4pc efficiency target. The plan being considered today meets that challenge.

'Within this period, the trust will be actively seeking new sources of income and working alongside commissioners to increase both the quality and quantity of local mental health services.

'We would like to reiterate that this is a proposed strategic plan and not a service plan. Our trust will make no changes to our services without full consultation.'

Members of the Campaign to Save Mental Health Services in Norfolk and Suffolk will be protesting outside the meeting at the Green Britain Centre in Swaffham about the proposed cuts.

A spokesman for the campaign said: 'The plan doesn't address the beds or community crises, and proposes more chaotic organisational changes. The plan also appears to have a massive black hole of millions of pounds of unidentified cost savings.'

Have you got a story about mental health services? Email adam.gretton@archant.co.uk