HOSPITAL bosses have postponed a decision on additional staffing for two wards because it is in "too big a hole" financially and first needs to find a way to offset the costs.

Nursing director Lorna Wilkinson was seeking approval from the Salisbury NHS Foundation Trust board for a six-month pilot period where both Pitton and Redlynch ward would have the same number of nurses at the weekends as they do on weekdays.

She told board members at the meeting on Monday the cost would be around £17k per ward but concerns were raised over the trust's growing deficit.

Ms Wilkinson said further investment of around £500k was required to enable the hospital to increase the number of permanent staff across all wards so it could reduce its reliance on expensive agency staff during both annual leave and study leave.

Paul Kemp, a non-executive director, said: "For this year, we have a £6m budget deficit and our best estimate is we are going to struggle to meet that - we can't make that problem worse.

"The whole trust board has to show some off-setters where some additional savings, or income, are offered to pay for it - we're in too big a hole to do do anything else."

The Revd Dame Sarah Mullally, who is also a non executive director, said: "There is a sense that we agree to this but we ought to be asking you to go away and come back and demonstrate that either, savings will be made to the overspend on agency staff, or, that something else in the organisation is being given up so we are shifting where we put money in the trust.

"It maybe, for example, that Malcolm [the finance director] may give up one of his finance people for it - it's about how a shift in our organisation can provide safe care."

The board's chairman Nick Marsden agreed, saying: "We need a case plan saying these are the potential savings or income - not just in nursing. I think the message is balance."

Finance director Malcolm Cassells said he feared increasing the figure of permanent nurses on paper would prompt nurses to “feel that they've got more that they've got to cover” and use agency staff to do so because of the shortage of nurses to recruit from.

He said: "If this was about having lots of nurses from which to recruit then it would be fine but increasing this is an artificial way because actually agency staff will be used."

Medical director Christine Blanshard said work was being done to ensure bed capacity was being used in the most efficient way and that it was expected savings would be found in the process which could go towards nursing provision.

As part of the nursing report, which is linked to the National Institute for Health and Care Excellence (NICE) guidelines, Ms Wilkinson said five midwives had been recruited at a cost of £187k.

The trust board approved the midwife recruitment and the use of £184k Resilience monies - a separate pot of funds - to fund extra investment in nursing in the emergency department.