Fears over South Western Ambulance Service planned cuts
Paramedics are warning the quality of the South West's ambulance service could be at risk.
More than 2,000 staff across the region are being asked if they would be prepared to accept a 1% cut to their pay and other changed conditions.
The trust said cuts were necessary as it needed to save £4m a year.
Paramedic and Unison representative Alan Lofthouse said any savings "shouldn't be made at the expense of frontline staff".
The South West Ambulance Trust said it was talking to staff about various proposed changes, including having less annual leave, working an hour a week or a day a year for no pay, along with changes to overtime and sickness benefits.
In a letter to staff from the trust's chief executive Ken Wenman, he said it would be impossible to provide the same level of service over the next five years because of what he called the "current economic climate".
Mr Wenman said the trust was having to look at employment costs, which were 74% of annual its turnover.
He added in the letter that if savings were not found the trust would have to consider job cuts.
A questionnaire was enclosed with the letter, with options for employees to indicate what cuts they might find acceptable.
The trust stressed it was just a consultation, and said staff had until 30 November to return the questionnaire.
Unison said it respected the trust's right to engage with workers, but said it would be very concerned if any changes were imposed without agreement.
Mr Lofthouse said: "Most staff have already seen their real term income reduce because we have been in a pay freeze for the last two years. Staff are already looking at having to work longer and get less.
"In ambulance terms that could mean ambulance staff working until they are 67. The job is physically and mentally demanding and that would create a huge impact on people."