Debt-hit health chiefs are trying to increase hospital waiting times to save cash.

Buckinghamshire NHS Primary Care Trust want people to wait longer to avoid paying out too soon to hospital bosses.

Oxford Radcliffe Hospitals NHS Trust, which takes county patients, is exceeding a new minimum standard that demands all patients are treated in 18 weeks.

But this means the PCT is having to pay out sooner – plunging its finances deeper into the red.

It came as the PCT admitted admitting its own management weaknesses led to “inaccurate” predictions about how much cash would be needed – and it now had to limit the damage.

Interim director of finance Jonathan Molyneux said the Oxfordshire trust had “been seeing people in much less than 18 weeks and we are trying to manage back nearer to the 18 week target”.

He said this “doesn’t mean that patients aren’t going to be seen, it means they are going to be seen in the time agreed” in original contract deals between the PCT and hospital trust, which Bucks patients can choose to go to.

A report to the PCT said this would still lead to it spending £3m more in Oxfordshire than planned – adding to a spiralling overspend expected to be at least £7.5m by the end of the financial year.

A PCT report says it needs to “control and reduce activity levels” at the trust.

Overall, the PCT warns hospitals seeing too many patients and too quickly is putting massive pressure on its finances.

A report says “over performance against the 18 week target continues to be a factor in the deterioration” of its plans for all hospital trusts it buys services from.

Under new rules hospitals always get paid for work carried out, whereas before “bulk” deals were struck in advance with the PCT, giving it more certainty over how much cash was needed.

This means the PCT has to pay for every patient seen, meaning hospitals which see patients quickly can demand payment sooner.

The PCT also wants to see “reductions in the activity” levels at Buckinghamshire hospitals, where most of its cash goes.

This is still expected to see the PCT spend £4.6m more with Buckinghamshire Hospitals NHS Trust than planned.

Today it emerged the authority is in dispute with the hospital trust as the PCT is questioning some demands for payment from BHT.

At this morning’s meeting of the hospital trust board, director of finance Tom Travers said the PCT had raised a “number of contract challenges”.

This, he warned, could pose a “threat” to the trust’s bid for prestigious foundation trust status, which would give it greater freedom from Government.

Ministers demand trusts have a £1m surplus to get the status – and BHT could slip under this level if it loses the pay rows with the PCT, Mr Travers warned.

Its chief executive, Anne Eden, told Bucks Free Press today she was happy to try and reduce patients coming to hospital with the PCT, thus saving the PCT money.

For example, patients with long-term conditions could be managed by their local doctors’ surgery, she said.

But Ms Eden said: “If the work does take place it has to be paid for.”

The total overspend on hospitals is now expected to be a minimum of £7.5m at the PCT, which is given about £360m a year to pay for all NHS care.

Board members were told yesterday it was £7m in the red seven months into the financial year.

Even the managers managing the financial department are overspent. The directorate of finance and business management is £436,000 in the red “due to agency and project staff and this will continue until recruitment is completed”.

Critics have said the PCT is under funded as Buckinghamshire is perceived by Government as being “healthy”.

Yet another report by the PCT laid some blame with its own managers for not being able to see the financial problems ahead.

A report says: “The impact of the over performance at BHT and under other acute contracts noted above and inaccuracies in original PCT budgeting have led the PCT to forecast a deficit.”

There were “financial and budget management weaknesses” said the report, by PCT officer James Friend.

This included a “lack of ownership” over budgets, “variability in authorisation levels” and a “lack of consistency in business case preparation”

Yet he pledged efforts were being made to turn it around. New HR boss Jane Dudley would create a more “effective organisation” his report said with a focus on improving officers’ “competency and capacity”.

To make better use of its cash the PCT is also urging GPs to refer patients to Independent Sector Treatment Centres, private-sector run centres which take some work hospital trusts would otherwise do.

These centres are paid irrespective of whether they carry out the work, leading to criticism from health campaigners that the private sector is being paid for, in some cases, doing nothing.

Mr Friend’s report said the PCT needed to “fully utilise” the centres to “make use of the committed to contract levels”.

Consultants told the PCT bosses earlier this year it had to spend £22.5m less to break even.