(Image: PA)
NHS staff could be offered voluntary exit arrangements or moved into different roles under the Scottish Government's plans to slash the number of health boards from 14 to two.
Ministers have confirmed that voluntary departures, redeployment and vacancy management are among the measures that could be considered as part of the major overhaul of Scotland's health service.
The options are set out in new guidance for NHS employees published on Thursday, amid growing concerns over the potential impact of the reforms on jobs and frontline services.
The Scottish Government has reiterated its commitment to no compulsory redundancies and pledged to protect existing pay, contracts and working conditions.
However, the document states that NHS organisations will consider a range of measures where changes are required, including "workforce redesign, redeployment, retraining and reskilling, natural turnover, vacancy management and, where appropriate, voluntary exit arrangements".
The Government said the aim was to manage changes in a planned and sustainable way while protecting and improving patient services.
The guidance does not specify how many posts could be affected or whether voluntary exit schemes will ultimately be introduced.
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The proposals form part of plans announced by First Minister John Swinney to replace Scotland's 14 territorial NHS boards with two larger organisations covering the east and west of the country.
Ministers argue the restructuring will reduce bureaucracy, eliminate duplication and allow more resources to be directed towards frontline care.
However, the reforms have sparked criticism from trade unions and medical organisations over the potential impact on staff, patient services and local accountability.
The shake-up could also extend beyond the territorial health boards, with ministers confirming they will examine opportunities to simplify the country's special health boards, including organisations such as the Scottish Ambulance Service, NHS 24 and Public Health Scotland.
The Government said no decisions had been taken on their future, with all options remaining under consideration.
It also confirmed that no decisions have been made on the location of a future NHS headquarters.
At last week's SNP conference, Public Service Reform Secretary Ivan McKee was accused of being "disrespectful" towards NHS workers during a heated exchange with Unison representatives.
The union's Scottish secretary, Lilian Macer, challenged the minister over his claims that the existing health board structure created barriers to moving patients, money and information around the NHS.
She warned against reforms becoming a cost-cutting exercise and raised concerns about the potential scale of workforce reductions.
The British Medical Association has also called for the plans to be scrapped, warning that centralising services could force patients to travel further for treatment and worsen existing health inequalities.
In its latest guidance, the Scottish Government said NHS employees would automatically transfer to the new boards in their existing roles without changes to pay, terms or conditions.
It added that any future workforce changes would be negotiated with trade unions through existing collective bargaining arrangements.
The document states that the reforms will be carried out "with the workforce, not to the workforce".
The Government also said the Health Secretary would agree a process with trade unions to ensure NHS staff could help shape the proposals.
However, the guidance confirms that the business case for the overhaul is still being developed, while detailed impact assessments and an implementation timetable have yet to be published.
Decisions on the future location of services and the structure of the new organisations also remain outstanding.
The Government said the costs and benefits of the reforms would be set out in the forthcoming business case.
Ministers have maintained that the changes will deliver a more efficient NHS, improve access to treatment and ensure services are better coordinated across Scotland.