NEARLY one admin worker for every three qualified nurses - that is the staffing balance inside Southampton University Hospitals NHS Trust, which was stripped of a star in the latest round of checks on Hampshire's health service.

The Daily Echo can reveal that last year the trust employed 1,147 administrative and estates staff compared with 3,400 nurses and midwives.

There were 836 dental and medical staff, 336 healthcare assistants such as auxiliary nurses, 964 technical workers like radiographers, pharmacists and lab technicians and 394 in the "other" category.

On top of that, they were taking on more than 60 extra staff every month in all departments.

Now health bosses say that staffing is a key target in the massive belt-tightening exercise being cranked up in the wake of the Independent Healthcare Commission's report.

As from yesterday, use of all non-clinical agency staff such as typists and secretaries will stop, triggering an estimated £20,000 saving at Southampton General Hospital and nearby Princess Anne Hospital.

Bosses say they want to end the quick-fix culture of employing costly agency workers to fill staffing holes.

A staggering 300 administrative posts are also set to go as Southampton University Hospitals Trust streamlines its office work, making better use of e-mail and new technology.

About 50 positions at the trust's headquarters are in line for the axe, as are 30 posts in outpatient services.

Ward closures could follow as healthcare makes a shift towards treating more people in their own homes.

Bosses insist they are not planning large scale redundancies, and say they aim to cut by "natural wastage," where staff who leave are not replaced.

A partial recruitment freeze introduced earlier this year has also been stepped up, with the whole organisation limited to just ten new staff each week.

Last Wednesday, the trust was told that their drop from the top three-star rating to two was purely down to balancing the books.

The trust ended the financial year £5m in the red, the first time it has had a deficit of any size - and trust chiefs set themselves their biggest financial challenge yet to make savings of £15m in 12 months.

Health bosses blamed the cash crisis on years of chronic underfunding - but Southampton MPs John Denham and Alan Whitehead hit out at the claims.

Labour backbencher Mr Denham said: "Broadly speaking, hospitals receive the same increases of funding everywhere and if other trust in the country can achieve their targets, it's disingenuous to blame lack of funding for your failures."

Southampton Test MP Mr Whitehead added: "I don't think the hospital is chronically underfunded for the work it does."

The true story behind the crisis is more complicated and widespread than the simple statistics reveal.

Over the years a gap has developed between the trust's income and what it spends, principally because the trust is providing services for which it is not being fully paid.

It currently receives money for operations from Primary Care Trusts, responsible for buying services to meet the needs of local populations.

But new rules set to come in next April will for the first time completely reshuffle the payment process.

Called a tariff charge, it will standardise payments for operations across the country.

And because Southampton hospitals are currently receiving less for services than the national average, they are in for a massive windfall.

Finance bosses conservatively estimate the trust will rake in more than £15m a year extra.

While the trust's cash worries will be solved in an instant, the funding hole will be passed on to Hampshire's PCTs.

Ben Lloyd, director of finance for SUHT, said: "We will be out of debt but it will have been passed on somewhere else. It's about where the deficit lands when the music stops and we're not interested in that. We want to change the record."

It is the need to "change the record" that is triggering sweeping changes in the trust at the moment.

Since April they have saved about £1.3m - but it is well short of the £2.8m target for this point in the year. The number of staff on the payroll has also hardly reduced at all.

So, following the star rating disappointment, bosses holding the trust's purse strings have stemmed the cash flow still further.

All departments are being asked to come up with money-saving plans by the middle of August. One of the hotspots is agency nurses, who drain the trust's money-pot of a staggering £60,000 to £70,000 each week.

Before cutting back, however, the hospital has to start recruiting more nurses - and a major drive to promote flexible working hours, on-site nursery, term-time contracts and family-friendly policies has been introduced.

It is all working towards a long-term solution to Hampshire's healthcare budget headache.

But what does it mean for the trust's 115,000 inpatients and day patients, the 85,000 annual emergency cases and 350,000 outpatients?

Mr Lloyd said: "We're doing everything that we possibly can to avoid impact on patient services. We are acutely conscious of that.

"It's all too easy to save money and damage something else, but that's the last thing we want to do.

"We are trying to do this sensibly, sensitively, and in a way that delivers the fund savings but that also delivers much longer term financial viability for the whole community."