Fourteen jobs have been cut at Wairarapa DHB to create one management team across the Wairarapa and Hutt Valley DHBs.
In total, 41 positions have been disestablished, with Hutt Valley losing 27 roles.
Chief executive Graham Dyer said it was hoped the new structure would be in place by April 5.
The staff most affected by the joint structure are in senior management and executive positions.
The new structure will include 10 new executive positions and 15 in management.