UNIONS have questioned the impact on the public and health workers as hospitals face having to find more than £45m in savings.

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

There would also be renewed pressure on GPs to ensure they do not refer people to hospital unless they definitely need to be admitted.

A similar amount was trimmed off spending last year by Oxford Radcliffe Hospitals NHS Trust.

The trust announced this week it came close to reaching a projected saving target of £44m for the just-ended financial year.

But it still looks to have ended with a deficit of £3m.

Trust spokesman Heather Barnett said managers and clinicians were already being asked to find fresh savings.

She said: “At the moment we anticipate if we do nothing, our budget will be at least £45m short by March 2011. So, we must reduce our costs by this amount.”

The underlying gap between the trust’s costs and income is currently put at £12m. Like all trusts it will face a 3.5 per cent reduction in money from the Government for services, amounting to £23m.

But the John Radcliffe and other local hospitals will also have to brace themselves for hefty cuts in income amounting to £10m from NHS Oxfordshire, the local primary car trust.

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

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

Taiwo Rasaki, the chairman of Unison’s Oxfordshire health branch, said: “We are very concerned 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.

“We don’t see why working people should pay the price of the economic crisis when the bankers that caused it get multi-billion-pound bail- outs.”

Ms Barnett added: “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 Unison, said savings were only achieved last year by the loss of hundreds of jobs.

And Mr McKendrick warned further savings in excess of £45m were certain to hit the quality of care, with staff “having to be worked into the ground”.

He 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 now denying.”

The trust and Unison are in agreement about the pressures created by demands on hospital services in Oxfordshire rocketing in recent years.

While the budget for patient services has gone up from £300m to £625m in a decade, 10 years ago staff were seeing half the number of emergency cases and 200,000 fewer out-patients a year.