The region's biggest health trust today starts life in financial special measures as NHS bosses outlined a raft of plans to bring soaring NHS finances back under control.

Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) was one of five hospital trusts across England selected for the intervention after failing to meet its financial commitments, but chief executive Mark Davies insisted the trust's financial position was caused by 'demand, not ineffeciency'.

It comes as the trust this year faces a £32.1m deficit and aims to deliver a £17.6m cost improvement programme (3pc of its turnover).

The move, by regulator NHS Improvement and NHS England, is seen as a major 'reset' of NHS finances after the acute hospital sector recorded a deficit of more than £2bn last year.

Mr Davies, who is approaching his first anniversary in charge of NNUH, said auditors from PricewaterhouseCoopers had reported that the trust's financial plans were 'sensible' but concluded that it was not possible for the trust to meet the commitments ordered by NHS Improvement.

It means NNUH and NHS Improvement must agree a 'recovery plan' within a month, with NHS Improvement having the power to make key spending decisions or changes in leadership.

Mr Davies added that the trust's plan to expand services such as A&E and day-case surgery was 'crucial' to bring its finances back into balance. 'The demand we are faced with is rising relentlessly and we are treating more patients who require more complex care from a large geographical area.

'Our staff are doing an amazing job but they are under significant daily pressure which is not sustainable.

'We remain committed to demonstrating that we are using taxpayers' money as efficiently as possible.'

Cambridge University Hospitals NHS Foundation Trust, which runs Addenbrooke's, could also being placed in financial special measures if it does not agree an economic plan with NHS Improvement.

Meanwhile the region's clinical commissioning groups (CCGs), which are in charge of the local health budget, have for the first time been given Ofsted style ratings. Norwich and North Norfolk CCGs were rated 'good', while South Norfolk, West Norfolk, and Great Yarmouth and Waveney were rated 'requires improvement'.

Both West Suffolk and Ipswich and East Suffolk CCGs were also rated 'requires improvement' while Cambridgeshire and Peterborough CCG was rated 'inadequate'.

A bruising day for trust

It was described by some as black Thursday for the NHS.

As NHS documents go this particular 78-page report included less of the jargon and more action.

Many will wonder what it means for our region.

Primarily the hospitals are being given individual targets, which if accomplished will release extra funds promised by the government in its oft-cited £8bn cash injection pledge.

That means no fines for hospitals that breach A&E, cancer, and referral-to-treatment targets, which is a particular relief for the N&N.

But for patients it could mean longer waits, as hospitals prioritise services accordingly with their individual plan with NHS Improvement.

The N&N trust's financial problems remains one of the biggest headaches for local health bosses.

With its crippling PFI the trust has not been able to turn around its performance, and that has never been more key as boss Mark Davies desperately wants to spend money on an expansion of A&E and day-case (ambulatory) services.

Financial special measures means more senior managers parachuted in to search for savings.

Can those managers deliver the goods where others have clearly not? And will that put services at risk?

Time will tell.