The Norfolk and Norwich University Hospital (N&N) is expecting an £11m budget shortfall next year, as the number of A&E patients continues to rise.

Bosses at the trust admitted the situation 'wasn't rosy', and made £28m of cuts in 2013-14 to remain £4.4m in the black.

But Julie Cave, the hospital's director of resources, said that for the first time ever the N&N had planned to go into the red - by an expected £11m for 2014-15.

There were 54,000 emergency admissions in 2008-09, and this had risen to 68,000 this year.

Ms Cave said that just 30pc of the cost of an A&E patient's treatment was picked up centrally, and the N&N had to foot the rest of the bill.

'The future isn't rosy at the moment,' she told last night's annual general meeting. 'Our position is strong enough to get through the next 12 months, but beyond that the future is uncertain.'

The N&N spends around £500m per year, including £270m on staff costs.

Anna Dugdale, chief executive, said she hoped cash could be saved by making administrative processes more efficient, making procurement savings and redesigning the workforce to ensure people's roles suited their skills.

The meeting heard that there had been big advances in cancer care at the hospital, bosses were working on patient outflow to address a shortage in beds and a new 350-space car park had helped reduce missed appointments,

The N&N scored highly on patient experience, but was continuing to work on issues including noise at night.

It has recruited four military veterans as part of a new initiative.

Ms Dugdale hailed fundraisers who helped buy new equipment including cameras for eye surgery.