Carol ClarkeNORTH Wiltshire's health chief has admitted her job is on the line unless she pulls services out of a £32m black hole of debt within three years.

North Wiltshire's cash-strapped health trust has been slammed in a scathing report that reveals it is riddled with debt caused by bad management and has overspent by £10m in the past year.

The District Auditor's report, published on Friday, reveals the prospects for Kennet and North Wiltshire Primary Care Trust are uncertain.

Responding to the report in an exclusive interview with the Chippenham News, Carol Clarke, chief executive of Kennet and North Wiltshire and West Wiltshire Primary Care Trusts, pictured, admitted there is a tough challenge ahead that could cost her the top job.

She said: "The bottom line is we have a statutory duty to make the savings. We are spending more money than we have and that's somebody else's money."

She said there was an urgent need to modernise services, which could mean all community hospitals become a thing of the past, with more patients being treated at home.

"We need to look at how we deliver services and whether we get value for money," she said.

"Pulling back on some of these services might not be a bad thing. The services we deliver in the main are quite old fashioned.

"At the moment there's very little choice for how patients who are dying end their lives. Most patients tell us they would prefer to be at home but at the moment it's a hospital or nothing.

"There is more than one way to deliver services and simply sticking to a model that was right 50 years ago is not necessarily best."

Mrs Clarke admitted getting the approval of the public was "probably the biggest challenge."

She said in three years' time she hopes there will be dramatic improvements to the health care provided in north Wiltshire.

"We need to be in a situation where we meet standards of dignity and privacy for patients and where our staff are working in good quality conditions," she said.

"We should be at the cutting edge of provision and not at the tail end."

The report slated the PCT for poor money management, unrealistic savings plans and inadequate budget setting.

It described a long history of financial problems and serious failings in financial management, which the trust has been slow to address.

The report said the PCT is developing plans to deal with the failings and there are some encouraging signs.

District auditor Stephen Malyn said: "The PCT has suffered since its establishment from poor management arrangements and a track record of not delivering financial savings.

"The PCT now has a new management team which has begun to take action to address these failings. There are some early signs of improvement but there is a long way to go.

"The scale of the financial recovery required over the next three years is significant and success will only be achieved through major changes to current NHS services and the support of the public and other stakeholders."

It said a critical success factor for the PCT will be whether it engages with the public and seeks their support in its planned changes.