North Norfolk patients have been warned that 'there is very little wriggle room', with possible difficult decisions ahead, as health chiefs shake up services in a bid to cope with a £14.6m funding cut.

The area's clinical commissioning group (CCG) discussed its shrunken budget, to be introduced from April 1, during a meeting of its governing body at the Aylsham Care Trust Centre yesterday.

Chiefs are crossing their fingers that the CCG will receive up to £3.4m from NHS England – but have been told to look at their budget savings first.

To cover the shortfall, the CCG is having a radical look at how it delivers 27 different areas of care to save £9.25m in the first financial year, and between £4m-£5m the following year.

Mental health services will not be affected.

Helen Stratton, chief finance officer of the CCG, told the governing body: 'This particular plan presents quite a few problems. I have shaved off as much as I can. The current proposal leaves us with very little wriggle room for anything unexpected.'

The changes will be made through a quality, innovation, productivity and prevention (QIPP) programme, which looks at the 27 different health areas.

'If we don't get any of the NHS England support the only thing we can do is increase our QIPP plan, which will lead to very difficult decisions,' Mrs Stratton added.

A new Community Engagement Panel, made up of people including patient group members and older people's groups, will be involved in the QIPP process. The panel meets monthly.

David McNeil, on the governing body and chairman of the Community Engagement Panel, said: 'We have to fight for our future.'

The CCG is receiving £211m for 2015/16 from NHS England.