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Meanwhile, a third of specialist nurses say their organisation is operating a vacancy freeze and 27 per cent said services were actively being cut, the survey found.

Twelve per cent of nurses who took part had seen their post downgraded or re-banded, and a further 17 per cent were currently facing this threat. Almost half of nurses in the survey had been at risk of downgrading at some stage.

The survey, of 330 specialist and experienced nurses across the UK, reveals that cuts initiated to relieve deficits two years ago have continued despite the NHS heading for a £1.8 billion surplus this year.

RCN chief executive and general secretary Dr Peter Carter said: 'It beggars belief that despite the NHS being on track to register a £1.8 billion surplus, specialist nurses are continuing to be targeted in a bid to cut costs.

'These are the very nurses who will be at the centre of the government's plans to deliver care closer to home.'

Dr Carter said specialist nurses would quit the NHS if they were targeted for redundancy or if they were denied the opportunity to make full use of their skills.

Diabetes UK chief executive Douglas Smallwood said: 'Research has already shown that a decline in diabetes specialist nurses has led to a rise in emergency hospital admissions for short-term diabetes-related complications such as hypos.

'The potential long-term impact of cuts from diabetes complications and the burden on NHS resources is alarming.

'Decision-makers must invest in specialist care to deliver patient-centred care rather than cut costs and jeopardise people's health.'

The survey also showed that 45 per cent of these nurses have been forced to work outside their specialist area to cover staff shortages.

More than two-thirds - 68 per cent - say that the number of patients they see on a daily basis has increased since they started their current job.

Just 51 per cent of nurses who took part in the survey felt their employer valued their work.

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