Union leaders at Oxford's Nuffield Orthopaedic Centre have said staff morale is at an all-time low.

Representatives from unions, including the Royal College of Nursing and Unison, have told managers at the hospital that workers feel exhausted and under-valued.

NOC chief executive Ed Macalister-Smith said a staff survey was now being started to look at ways of improving working conditions.

He said: "We are certainly always looking at ways to improve staff morale.

"I don't think it's in any way at rock bottom. Morale is difficult in the NHS, but we're more fortunate than many other places."

Union members, led by RCN member Gill Morris, highlighted problems in a report challenging proposals to increase staff parking permit charges from £20 to £60 a year. An exclusion zone for permits was also planned, meaning more staff would not be able to drive to work if their journey by bus took less than an hour.

Union representatives said that during four meetings, staff had listed problems they constantly had to face, including:

Stress because of imminent development work at the hospital

"Immense pressure" to deliver Government waiting-list and financial targets

Recruitment problems

Lack of facilities, including the closure of a swimming pool and massage service over the past two years

Senior managers not listening to staff.

Ms Morris said: "We are trying to show the trust that increasing staff parking charges by 200 per cent is just about the final straw for many staff members.

"Morale is at an all-time low. Staff are exhausted and feel under-valued and poorly supported by the NOC management."