Staff were told on Thursday 126 roles will be disestablished, and another 142 vacant roles will go unfilled, bringing the total number of roles to be disestablished to 268.
The total number of staff in commissioning when Te Whatu Ora was formed was 1004.
Cuts had reduced that to 756 in the first round of restructuring, and now to 482 - more than half.
PSA national health sector lead Ashok Shankar said this was the team which funded, monitored and commissioned health-based services, including the management of thousands of contracts within the sector.
An employee in the commissioning team, who RNZ has agreed not to name, said it was a tough time.
"I think it's fair to say we are all feeling weary after all of the changes we've been through in the past two years, and especially as a lot of staff actually worked extremely hard through Covid to support the public health response. It's just been a tough four years for us."
Shankar said the cuts were "savage", employees were feeling "shell-shocked", and it would certainly result in the cutting of services.
The distinction between frontline and backline was "a political creation to make the community feel that there's all of these unessential people out there being paid for doing nothing".
"Within health there isn't a frontline and a backline, it is a team, and the team delivers healthcare," he said.
"You don't have people in the backline who aren't essential, they ensure that the people who actually touch the patient have all the resources to actually deliver the care.
"Without them, the clinicians on the frontline are not going to be able to do their work."
A spokesperson for Te Whatu Ora said: "Health New Zealand is continuing work across the organisation to ensure we live within our budget and focus on providing New Zealanders with easier and faster access to healthcare".
It said other than some leadership changes, there was no formal change process at this stage for commissioning.
