Hereford Hospitals Trust is facing its worst cash crisis in 10 years, writes LIZ WATKINS.

It blames a massive workload for building up a potential debt of £1.2 million by the end of March.

"This is the tightest financial situation we have ever found ourselves in,'' confirmed chief executive Jeremy Millar.

With beds at Hereford County Hospital nearly always filled to capacity the trust has been forced to spend extra money on nurses to keep services going. And with more beds 'blocked' by people who should have been moved on to other care facilities it has paid private hospitals to treat many of its patients so that it can meet Government waiting list targets.

The added costs have eaten into the Trust's £67 million 2002/3 budget which was largely based on an 85 per cent bed occupancy at the hospital.

Mr Millar said if the situation was to improve next year everyone would have to get to grips with social care of the elderly and he agreed with his colleague Paul Bates, chief executive of the Primary Care Trust that bed blocking, or delayed discharge, in all hospitals in Herefordshire was the most single important issue facing the NHS in the county. The County Hospital should never have more than six beds tied up through delayed discharge but it was often 20 and sometimes 30.

To ensure that routine surgery lists could continue and targets met the Trust was this year spending around £1.2 million on sending patients to private hospitals.

Mr Millar said that co-incidentally this was the amount the Trust was predicting to be overdrawn by the end of the month.

But the chief executive was reasonably confident that resources could be found to reduce the deficit to allow the Trust, which had never had a 'major overspend' in 10 years, to actually break even at the end of March.

He was hoping the Primary Care Trust, which is in charge of the NHS budget in Herefordshire, would contribute an extra £500,000 and talks about this were taking place. His own trust was considering many ways of earning more money, both from the extra work it had done and the service it provided for other health authorities. Adjustments were also being considered, which if implemented could cover the remaining £700,000.

Paul Bates of the PCT said maintaining financial control in the whole of the health community in Herefordshire was imperative. He confirmed talks were continuing with the Hospital Trust on its current financial problems.