Specialist nurses feel their jobs are threatened despite a predicted NHS surplus of nearly £2bn, according to the Royal College of Nursing (RCN).
It said making cuts to specialist nursing "flies in the face" of health minister Lord Darzi's aims to move care closer to home.
A total of 328 nurses were polled for the RCN.
A third said their organisation had a vacancy freeze, and one in four said they had been at risk of redundancy, with 20% of those still at risk.
Almost half (45%) said they had been forced to work outside their specialism to cover shortages, and nearly one in five (17%) were currently at risk of being downgraded, while 18% had been at risk, and almost 12% said their post had been downgraded.
RCN chief executive and general secretary Dr Peter Carter said: "One of the planks of Darzi is specialist services so it flies in the face of that development at this time to be cutting back the people who are the most highly trained and have really specialist knowledge of these conditions."
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What do you think of the increased cutbacks? Are you afraid of being made redundant? Your comments: (Terms and conditions apply)
"No I am not afraid of redundancy. However I am extremely concerned about how they are streamlining jobs and using less qualified and less skilled staff to carry out the care." - Mrs Carol Young, Scotland
"No, surprisingly I am not. There is a vacant post for a CNS which has not been filled since Jan 2006. It was advertised thrice but not filled." - Jemma Joseph-Crosby, East London
"I am not afraid of being made redundant as I can put my skills learnt throughout my nursing career to good use even though the role my be a voluntary one. Once a nurse I will always be a nurse. I love what I do for contributing to patient care in whatever way my own contribution can be measured." - V Henry, London
"Yes I am a practice nurse and with all this talk of polyclinics and private companies buying GP surgeries, I feel very vunerable. The threat of downgrading but being expected to function in the same role is very real. I am nine years off retirement and dearly wish it was less. I love my job but the insecurity and stress just isn't worth it. I worked in an area in the past which was taken over by a private company and a lot of experienced (better paid) staff were made redundant." - Maureen Grant, London
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