More than 30 GP practice workers face uncertainty after health chiefs announced an intention to 'work differently'.
Royal Primary Care (RPC) has launched formal talks with its 33 administrative staff, the Derbyshire Times has learned.
The news comes after it was revealed that RPC was awarded a 15-year contract to run GP practices in Grangewood, Staveley and Inkersall, serving more than 20,000 patients in Derbyshire.
RPC - whice took over the troubled former Holywell Medical Group - is part of Chesterfield Royal Hospital NHS Foundation Trust.
An RPC spokesman said: "Over the past year RPC has reviewed all aspects of the workforce, including management and clinical staff, and has now entered the final phase starting a 30-day consultation with our colleagues in administrative roles.
"Historic work patterns, along with feedback from staff and patients, show that we need to work differently to make sure that practices are appropriately manned when patients need to contact us the most.
"Along with staff side representatives, we are seeking the views of our administrative teams in one-to-one and group meetings to work out the best way to make this happen.
"This will include different shift patterns, including part-time shifts, and a clearer salary structure in line with surrounding practices which provides pay progression for staff.
"No decisions have been made and we are working very closely with staff, offering our full support during this process which will run until the middle of September."