ONE year ago there was doom and gloom in Hampshire's health services as the Daily Echo reported that jobs and services would have to go as trusts battled to balance the books. Twelve months on and history is repeating itself as the real cost of solving the county's NHS cash crisis starts to take shape...

JUST hours after the Daily Echo lifted the lid on Hampshire's NHS cash crisis, the human cost began to emerge.

Health chiefs admitted the financial situation could be even worse than first thought.

Last night they revealed that hundreds of jobs could be axed and wards closed - for the second year in a row - in a bid to balance the books.

The trust which runs Southampton's three main hospitals now says it needs to save £38m over the next three years to wipe out its debts.

If that target is missed, the Health Secretary - whoever that is after the expected May general election - could be called in to investigate.

Bosses are drawing up new plans to slash 300 posts and more wards over the next 12 months to save £17m. They believe the posts can be lost without compulsory redundancies.

The bombshell comes on top of the loss of about 350 staff in the past 12 months.

Union leaders condemned the cuts and said they would affect the service to patients.

The trust, which runs Southampton General, the Princess Anne and the Royal South Hants hospitals, starts the new financial year next week with a £14m deficit - nearly three times as big as last year.

It is not yet clear exactly how the savings will be made but spokesman Peter Campion warned today that job losses were on the cards.

He said: "Hampshire and Isle of Wight Strategic Health Authority is looking for an average five per cent reduction in staff in primary care trusts and hospital trusts.

"For us, that would equate to about 300 posts. Natural wastage will account for all of that if you consider our staff turnover figures."

He also warned that hospital wards could close, possibly those specialising in the care of elderly people.

"There are extra social services beds opening up later this summer, and people who are in community hospitals are likely to go into those," said Mr Campion.

"That means patients who are ready will be moved from acute beds, into community hospitals. At the moment, there are 65 beds here occupied by people waiting to move on.

"If we claimed back half of those beds, that's a ward that you don't need anymore.

"The likelihood is that, yes, we will close wards. We only need to deliver the services that people are commissioning us for."

The shake-up follows the loss of 350 posts last year, including 150 agency nurses, and the closure of four wards.

Last year, the closure of the nurse-led unit at Southampton's Royal South Hants infuriated some union members who had worked for decades on the ward and had no jobs to go to within the acute-care trust.

Today Unison spokesman Mandy Weldon told the Echo: "We can't condone further job losses.

"We hope that it will be dealt with in an appropriate manner and we will be working with the trust and our members.

"But this is going to have an impact on our members and, ultimately, patient care will suffer.

"It's not the fault of 300 members of staff that the trust and the health authority has got themselves in this mess.

"We will be looking for redeployment and retraining of staff. We need health service workers."

Other cash savings measures include creating specialised centres for surgery at either Winchester or Southampton hospitals to avoid duplication.

Yesterday the Daily Echo revealed the financial crisis gripping healthcare in Hampshire, unveiled in an urgent letter sent from hospital chief executive Mark Hackett to his counterpart at the strategic health authority, Gareth Cruddace.

He called for immediate action to speed up the cash-saving process, as NHS services grapple with a £40m hole in their budgets.

The extent of the savings required at SUHT were contained in a report produced by external auditors.

The damning study points the finger at "a degree of mistrust" between health organisations, a lack of appreciation of the urgency of the situation among top health bosses and the delay of a crucial tariff system for operations.

SUHT paid business advice firm KPMG an undisclosed figure to look at its failing recovery plan.

The trust saved £12.5m last year, missing its target by £2.5m.

Auditors spent from January 10 to February 4 this year reviewing the bleak situation - and the report warned that a "radical approach" was needed to recoup the cash, with greater collaboration between organisations.

KPMG dropped a bombshell over the lack of communication between local NHS trusts and primary care trusts as they fought tug-of-war battles over patient care bills.

It said: "There is evidence of a degree of mistrust between the organisations."

KPMG hinted that alarm bells had been rung by the trust's frustrated board members.

The auditor stated: "Several calls were made for a greater level of intervention from the strategic health authority given the urgency of the situation."

Eileen Spiller, director of delivery and service improvement at the Strategic Health Authority (SHA), defended her organisation's role in the recovery plan - and said that dialogue between organisations had improved.

"All NHS organisations have a duty to balance their books. Financial recovery across Hampshire is crucial and the NHS locally knows that the SHA expects organisations, which have received record levels of growth in the past three years, to work together to ensure they deliver high quality healthcare and break even financially," she said.

"Radical action was taken by the SHA early last year in developing the Beyond Healthfit programme. Refocusing leadership was part of this process and aimed to increase leadership capacity and expertise within the PCTs, reduce complexity and duplication, and develop common approaches."