THE boss of Poole hospital has warned of increasingly tough times ahead with rising demand from patients, no more money in the next financial year and £11m in savings to find.

But Debbie Fleming says she remains positive about the standards of care her staff can deliver.

Judging by the national picture and warnings from pressure groups and the medical profession, the NHS is facing the bleakest period in its history.

"There is no question that our hospital extremely busy," she told the Echo on Friday at the end of another challenging week, nationally and locally.

"We are always busy but obviously more so over the winter.

"What we can’t get away from is that the financial position of the NHS is extremely challenging and the situation with social care with our local authority colleagues is just as bad, if not potentially worse.

"We have been very worried going into winter period.

"Work in the NHS keeps on going up so the activity in the hospital is higher than ever. We have been very concerned.

"As far as the winter period is concerned, we saw 14 per cent more patients between Christmas and New Year compared with the same time last year. We have had some hugely busy days.”

Partnership working with organisations including the ambulance service has stopped the system tipping over the edge.

Poole has not called ‘black alert’ at any point – which is in effect a distress call for help from elsewhere.

"Our worst day was the day after the New Year holiday and we were a long way off achieving our four hour waiting time target for accident and emergency and in fact we have been very worried about much longer waits than that. We had one 12 hour wait for example due to particular circumstances.

"What I would say is that when we see patients waiting a long time, no matter how long it is, the priority is to provide great care. So the waiting time gives us an indication of how busy it is and how few beds we might have available but I do know that those who were waiting were looked after, not just left on trolleys.

"They had proper beds, meals, drinks and the staff put that as their top priority. The waiting time targets are important but they are not as important as giving good care.”

As far as the overall national picture is concerned Mrs Fleming says demand is rising and finances are tight. “I don’t think people can see an obvious way out of this at the moment except pulling together and doing the best we can. We certainly cannot continue to deliver care to the same standards we would like with these numbers coming through and midst of all these pressures. Something’s got to change.

"We are very proud of what we have done in Poole over the past few years in delivering our financial plans. For next year the savings plan is the highest it has ever been, £11m is much higher than the £6m we would expect to be finding and at this stage we haven't identified all of that. We will have to do this with a sharp intake of breath because it is very, very steep."

As well as rising demand and ever tightening finances, there is a shortage of GPs, specialist nurses and emergency medical consultants.

Which brings us to the clinical services review, part of a wider, national sustainability and transformation plan.

Dorset's clinical commissioners, health chiefs who buy the services, want to make Royal Bournemouth the major emergency centre and Poole the centre for planned care.

They say Bournemouth scores better in access and affordability if services are revamped.

Mrs Fleming would like it the other way round believing it would least disruptive for local people, but has pledged that whatever is decided "we will make it work. We have to work together to do what is best for patient care across the whole county. We absolutely support the case for change."

She paid tribute to her 3,500 staff for their dedication and hard work. Morale is good she says, despite the uncertainty in the NHS.

The CSR is currently out for public consultation until the end of February.

"I'd like everyone to take part and have their say. This will be the biggest shake up of health care in Dorset since 1948 and it is personal for every single one of us. One thing is certain. Things cannot go on as they are."