A Midland health trust which has seen its predicted debts double in a month yesterday announced plans to axe up to 90 jobs.

Coventry Teaching Primary Care Trust (tPCT) is making the cuts as part of a savings plan to recoup £29 million, about 7.5 per cent of its budget, by March 2007. This initiative was meant to help the trust break even but yesterday its board learned the projected year-end deficit had almost doubled from £5.9 million to £10.7 million since last month.

A 30-day consultation period will begin by the end of this month, with up to 50 clinical and 40 corporate posts expected to go by early December - saving more than £1.1 million.

Compulsory redundancies have not been ruled out.

The trust, which employs 1,800 staff, is responsible for all primary care services including walk-in clinics, GP services, dentists, psychological services, palliative care, physiotherapy and family health. Community nursing and school nurses services are also part of its remit. It will also have to cut management costs by 15 per cent as part of a national Department of Health directive.

Stephen Jones, joint chief executive of the trust, said: "We've known about the saving plans for some time, but we've only recently identified the impact it will have on staffing levels.

"Basically some of our savings plans just aren't working and some of our solutions have turned out not to be possible.

"Yes, there will be an impact on patient care, but we need to look at whether these patients really need someone to go out to their home. These cuts will not affect GP services, this reorganisation is more focused on clinical and community services. As managers we are expecting serious questions to be asked by the board over our financial position, but no-one is talking about stepping down at the moment."

Last month trust board members noted its balance sheet position would "remain relatively stable" except for a £22 million payment to the University Hospitals Coventry and Warwickshire private finance initiative creditor, which was included on March 31.