More than 40 jobs will be disestablished at Hutt Valley and Wairarapa district health boards to make way for one management team.
Chief executive Graham Dyer confirmed the new structure would be in place from early April.
Most senior management roles will be disestablished to make way for a new management team overseeing both DHBs, including 10 new executive roles. That means there will be only one chief medical officer, one chief operating officer and one executive director of nursing and midwifery, when previously each DHB had its own.
Fifteen new management roles will also be created.
The change means 27 positions at Hutt Valley would be disestablished and 14 at Wairarapa. Eight of these positions are currently vacant.
It was not clear how many people would be left without a job, as some people might move from executive roles to management or elsewhere in the organisation, Mr Dyer said.
He wanted to commend senior managers in both DHBs for their "courageous and exemplary" professionalism through the change process.
He said the elected boards would remain separate, to ensure "local accountability for the way services are provided".
Nearly 750 staff from both Wairarapa and Hutt Valley gave feedback on the new management structure.
Concerns were raised around it being too lean and having insufficient management resources across both DHBs.
The changes follow the appointment of Mr Dyer as joint chief executive for Hutt Valley and Wairarapa in December.
It is also another step in the "3DHB" plan, which was sparked by senior doctors three years ago to investigate combining medical services at Hutt Valley, Wairarapa and Capital & Coast.
The plan to address "sustainability, access and quality issues" was released in October. It flagged shifting to a sole chief executive and management team for Hutt Valley and Wairarapa.
Meanwhile, Hutt Valley staff have also been asked to save $5 a day each as the organisation grapples with a budget blowout.
A health board meeting last week was told January's financial result was $386,000 over budget. Figures for the financial year to date are $2.3m over budget.
Spending on magazines and newspapers has been cut, along with catering for meetings, as part of an "I'm thinking lean" campaign.
Overtime has been limited, and staff have been asked to turn off their computers at night to save power.
In a message to staff, Mr Dyer said patients could also help by turning up to appointments, or letting the hospital know if they could not, so the place could be filled.
- The Dominion Post
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