It has been revealed that NHS Borders has to save £10million over the next three years – half of it within the next 12 months.

The cuts and a revamp of services will be felt across the Borders and in all sections of healthcare.

Health managers have blamed the situation on what they describe as a tight financial settlement from the Scottish Government – and have asked staff to come up with ideas of how some of the savings can be made. One decision already reached is to close Ward 14, the palliative care ward, which includes patients with terminal cancer and others who require almost constant pain-relief treatment.

Patients from Ward 14 will now be treated alongside stroke victims currently cared for in Ward 11. This decision will be seen as the most emotional of the cost-cutting measures.

Neither ward is constantly at 100 per cent capacity and the change has been described as a temporary move until November or December. But it is known that health managers are talking with leading clinicians about making the situation permanent.

And satellite hospitals will not escape. Hay Lodge at Peebles, The Knoll at Duns and community hospitals in Hawick and Kelso have all been asked to contribute to a reduction in beds.

The original plan was that one of those hospitals would lose a ward. But talks yesterday decided that the load should be spread – each hospital will now lose four or five beds until the end of the year at least. Mental Health Services have also been told to make savings – again that is likely to be a reduction in the availability of beds.

Savings in non-medical services – departments such as finance, IT, human resources and planning – have already taken a big hit. Four staff have taken voluntary redundancy and natural wastage has been used to lose posts. There is been a reduction in the use of outside professional bodies. These and a number of other non-medical measures have slashed £3million from the budget. But that still leaves £2million to be found from services provided for patients.

Some of that will be found by a strict control on staffing. All managers have been ordered to identify how they can slash their staffing budgets by five per cent on an on-going basis over the next two financial years.

They have been told to have their plans in place by next month – a third of the savings will be implemented by March next year.

If managers fail to reach their targets they will not be allowed to fill vacancies. Even if targets are reached, bosses are giving no guarantees that jobs will be advertised. The use of bank and agency nursing staff is also to be cut back.

Health chiefs are also examining its capital programme which includes an £11million upgrade of A&E at the BGH into a state-of-the-art emergency care centre and early revamps of health centres in Earlston and Jedburgh, followed by the Roxburgh Centre complex in Galashiels.