Nurses may be offered an 'employment guarantee' locally or regionally in return for 'sustained pay restraint'. It could mean staff are moved across a region or sector rather than made redundant, he said.
The DoH has unveiled a raft of measures to increase productivity over the next five years in the document NHS 2010-15: From Good to Great.
Speaking at the document's launch in London on Thursday, Mr Burnham said: ‘It will require a difficult conversation with trade union colleagues, with trade-offs to be made about whether or not you can maintain staffing levels and what that means for pay, pay restraint or flexibility — working in different places - it's a difficult equation.
‘Let's work this through ahead of the coming period.'
The RCN said there was ‘much to welcome' in the report but said the NHS could not afford to cut nurse numbers as the demands on the system increase.
On Wednesday, in his pre-budget report, chancellor Alistair Darling revealed all NHS pay awards would be limited to 1% between 2011 and 2013.
