Coventry University Hospital says it hopes to avoid redundancies even though it has confirmed a cut of £25m to its annual budget.
A further £16m will also have to be saved in 2011/12, chief executive Andy Hardy told BBC News.
He said that while there is no planned redundancy programme, there could well be fewer staff at the hospital in two years.
The hospital's annual budget is £465m, he added.
Neither side of the political spectrum wants to admit this but the NHS is totally unsustainable in its present form.
