Hospitals in Oxfordshire will have to find more than £45m in savings in the new financial year.

Staff have been told the cost-cutting plans will rely on significant reductions in patient numbers admitted to hospital, shorter lengths of stay and fewer outpatient appointments.

And there will be renewed pressure on GPs to ensure “they do not refer people to hospital unless they definitely need to come”.

The newly-announced savings come on top of a similar amount having to be trimmed off spending last year by Oxford Radcliffe Hospitals NHS Trust, which runs the John Radcliffe and Churchill, in Oxford, and the Horton, in Banbury.

The trust announced this week that it came close to achieving its saving target of £44m for the just-ended financial year — ending up with a budget deficit of £3m.

ORH spokesman Heather Barnett said managers and clinicians were already being asked to find fresh savings. She added: “We anticipate that if we do nothing, our budget will be at least £45m short by March 2011. So, we must reduce our costs by this amount.”

Like all hospital trusts, the ORH will next year face a 3.5 per cent reduction in direct funding from the Government, amounting to £23m.

On top of this, the ORH will have to brace itself for a significant cut in income from NHS Oxfordshire, the local primary care trust.

With NHS Oxfordshire having to make savings of more than £200m over the next four years, the PCT will be seeking to cut back its spending on services it commissions from hospitals by £10m next year.

The ORH will also have to make savings of £12m to tackle a gap between costs and income.

The savings plan will be heavily dependent on hundreds of patients being diverted from hospitals to community-based health services, with more people having to be cared for in their own homes.

Ms Barnett said: “At the ORH we are already offering support to GPs and clinical colleagues in other hospitals, using email and the internet so that patients do not have to travel into Oxford and Banbury for advice and information that can easily be shared in their GP practice or their local hospital. GPs are doing more for patients in their own surgeries.”

But Ian McKendrick, county branch secretary for health workers’ union Unison, said savings were only achieved last year by the loss of hundreds of jobs. And he warned further savings of £45m were certain to hit the quality of care, with staff “having to be worked into the ground”.

Mr McKendrick said: “I have no doubt whatsoever that savings of this kind can be achieved. The question is at what cost to the public and health workers. There will be a huge negative impact on patient care, something that all trusts are currently denying.

“Our stewards are telling us that 600 jobs went last year at the ORH, with people not being replaced. We are also hearing about people having their job descriptions redefined, meaning they are paid less for doing the same jobs. We are now anticipating more attacks on jobs.”

The chairman of Unison’s Oxfordshire health branch, Taiwo Rasaki, said: “We are very concerned that Oxfordshire's population will suffer from poorer services and our members will be expected to fill in the gaps left by the cuts with no support and little reward.”