A staffing crisis looks set to help plunge a hospital more than £30m into the red.

Senior managers expect the Queen Elizabeth Hospital in King's Lynn to finish the financial year £34.2m over budget.

They blame the debt partly on the cost of hiring agency nurses and doctors to plug vacancies, which accounts for around a third of the figure.

The QEH is expected to be one of the worst-performing hospitals in the country financially when NHS figures are released later this week.

The disclosure came at a meeting of the hospital's board, which heard the trust was still 'in the foothills' of its improvement plan after being placed in special measures. Roy Jackson, its director of finance and resources said: 'It's a significant financial challenge for this organisation.'

Inspectors from the Care Quality Commission highlighted lack of staff on wards when they rated the QEH 'inadequate' in September. Today's meeting heard the vacancy rate had fallen slightly, from 10.8 to 10pc. But 30pc of the staff at the medical assessment unit, 19pc on Terrington and Stanhoe wards and 15pc in A&E were agency.

Nick Lyons, the QEH's medical director, said it was looking at ways to cope with expected winter pressures, including treating more patients at home and carrying out more day surgery.

Dr Lyons said the QEH was also looking at transferring cancer operations to the Norfolk and Norwich University Hospital if it ran out of beds. He added: 'It would be irresponsible not to consider that as a short-term option this winter.'

Senior doctors met on Monday to discuss the plan. In a statement afterwards, they said they feared it would compromise patient safety.

In public questions at yesterday's meeting Jo Rust, secretary of the King's Lynn Trades Council, said: 'How can you guarantee safety if you're expecting patients to travel 50 miles down the A47 to a hospital that's over-stretched, that's been judged inadequate, that's not meeting its cancer targets?'

Chairman Prof Steve Barnett said: 'There are a lot of considerations being taken into account. Whatever we decide has to be about patient safety first and foremost.'

Transferring operations will be discussed by the trust board next month.

Figures out on Thursday are expected to show while bigger hospitals have bigger deficits, the QEH has one of the highest ratios of debt in relation to its turnover, which this year stands at £189m.

After the meeting Mr Lyons said: 'The costs of nursing agency and doctor agency staff are a significant part off that. The £34m deficit we're talking about involves a significant number of agency staff.'

Mr Jackson said: 'What we would like to see is more people being trained and retained in the area so we're not paying an agency premium.' The hospital was meant to end the 2018/19 financial year with a £9.8m loss. Agency staff are expected to account for £9.6m alone.

Other costs ranging from a £1m loss of clinical income to a £700,000 car park extension and £627,000 in staff pay awards have help send the hospital further into the red.

North West Norfolk MP Sir Henry Bellingham said: 'I have been in closed discussions with Jon Green and others who are putting together, as we speak a plan to turn it around.

'The problems we have had in the past are so many interim positions but now we have full time, permanent directors and a very good acting chairman and soon to be new chairman, I am confident we will put a plan together.

'A lot of smaller hospitals are in debt due to staffing, it's as if they are damned if they do and damned if they don't. If they don't have the staff in place they aren't meeting the standards of safe care so they have to hire the agency staff.

'I am confident, if they are able to get the plan in place, they can turn it around.'