Hospitals in Sussex are more than £100 million in debt.

At the end of the financial year only one major hospital trust in the county has managed to break even and others report overspends of millions.

The financial problems have been escalating as hospitals deal with more patients than ever but don't get the funding to match.

This has led to cuts in beds, a drop in the number of operations, job losses and a fall in outpatients' appointments as managers work to get trusts to balance the books.

A lot of work has already been done, including cutting agency staff, but it has not been enough.

Bosses warn there are tough times ahead as they look for ways to make even more savings.

More job cuts and changes to patient services could be on the cards.

Surrey and Sussex Healthcare NHS Trust, which runs Crawley Hospital and East Surrey Hospital in Redhill, is the poorest performer.

It has an expected overspend of £21 million and an historic debt of £20 million, leaving it with an overall debt of £41 million out of annual budget of £138 million.

Royal West Sussex NHS Trust, which runs St Richard's Hospital in Chichester has an overspend of £20.9 million plus a further debt of £15.5 million, leaving it owing £36.4 million out of a budget of almost £87 million.

Brighton and Sussex University Hospitals NHS Trust is the largest in the county and runs the Royal Sussex County Hospital, Sussex Eye Hospital and Royal Alexandra Hospital for Sick Children in Brighton and the Princess Royal Hospital and Hurstwood Park neurosciences centre in Haywards Heath. It has an annual budget of about £330 million and has overspent by £11.2 million. It also has an extra £10 million debt from last year, giving it an overall debt of £21.1 million.

Worthing and Southlands Hospitals NHS trust has always managed to balance its books but this year it has struggled and overspent by £6 million out of an annual budget of £130 million.

East Sussex Hospitals NHS Trust, which runs Eastbourne District General Hospital and the Conquest Hospital in St Leonards, is the only trust to break even this year with its annual budget of £206 million.

However it overspent last year so still has debts of £5 million to pay back.

Teams of troubleshooting experts have been helping managers at Brighton, Surrey and Sussex and Chichester to draw up plans to get their finances under control.

Brighton published its Turnaround report this week with news that 325 jobs would be going and it was investigating all areas to find savings.

Surrey and Sussex Strategic Health Authority is carrying out a major review of all its hospital, primary care trust and community services to see what savings can be made and how they can be run more efficiently.

Areas of focus are treating more patients as day cases so they don't have to stay in hospital, which reduces demand for beds, and providing more services such as blood tests and X-rays at GP surgeries.