NHS jobs are on the line after a 30 day consultation has begun with healthcare workers in Solihull.
Staff at the Birmingham and Solihull NHS Cluster are entering the consultation as a new structure is introduced.
Hundreds of primary care trust staff across the West Midlands are expected to be affected by the changes.
No figures are available at this stage about how many staff in the borough would be at risk.
Union members claim many of the newly-created organisations that will run most of the NHS – clinical commissioning groups, commissioning support services and the NHS Commissioning Board – are only now calculating how many staff they will be able to afford to employ.
But Mal Madders, assistant chief executive, human resources/organisation development for Birmingham & Solihull Cluster and Black Country Cluster, said: “We currently employ around 2,300 people. The two clusters have embarked on a 30-day consultation with the appropriate staff.
“We would like to reassure patients that services will be unaffected by this process and we are determined to ensure a smooth transition as we prepare to hand over our role of commissioning to the new organisations.”