Elaine Way, Chief Executrive of the Western Health and Social Care Trust this week announced that as part of the Comprehensive Spending Review efficiency saving proposals, the Trust must make savings of £10.3m this year, £12.3m next year and £14.4m in 2010. £6.3m of these savings will come thorugh the review of public administration.

132 posts are now at risk, including one in four administration posts and a number of plans have been recommended for more community based care.

The news comes just two weeks after the Trust announced that last year it had managed to balance its books, making up a £14.9m deficit.

"We balanced our books because we tightened our belts," said Mrs Way, "however we have to sort out once and for all the underlying financial pressures."

Mrs Way said that although the Trust was receiving £36.2m investment over the next three years from the Health and Well Being Investment plan, this money was ringfenced for specific services the Trust currently provides.

She added that while 132 posts were at risk, the Trust was committed to doing all it could to avoid compulsory redundancies.

Current proposed efficiency savings include a change in the current policy of admitting patients to hospital the night before an operation, and instead admitting them on the morning of an operation.

Margaret Kelly, Director of Acute Services said the aim was to ensure that people only come into hospital for treatment when they needed to be in hospital and so facilitate earlier discharge.

"Proposals are in line with best practice," she said.

Further proposals include the implementation of a 'one stop dispensing system' where the hospital will now use patients' own medication brought into hospital by keeping their medicine in a locked cabinet by their beds.

There will also be a review of pathology services, moving some procedures to day and outpatient cases and the implentation of new models of emergency care and medicine.

In the primary care and older people's service proposed efficiency savings will be made by reform of residential care, domiciliary care and geriatric medicine with the aim of reducing long term dependency and maintaining people in the community.

In the mental health and disability directorate, the aims are to maximise independence and maintain people in the community. These include a redesign of existing services at Gransha, Tyrone and Fermanagh with two smaller units and a relocation of adult respite services form Dungiven Road to Lakeview.

Director Trevor Millar said the aim was to move people away from institutional care to one where care was provided in the community.

"We want to maximise the independence of the individual in the community," he said.