Mr Joe Lusby, Deputy Chief Executive and Director of Acute Services at the Western Health and Social Care Trust (WHSCT) said the local health body - that serves the wider Londonderry area - is being asked to implement the cuts in the face of an increased demand for services.
The Trust has been asked to make wide-ranging efficiency savings as part of the UK-wide Comprehensive Spending Review (CSR) - a governmental process carried out by HM Treasury to set firm and fixed three-year departmental expenditure limits.
But providing evidence to the Stormont Health Committee recently Mr Lusby said achieving savings in acute services - when more and more people were demanding them - was a hard ask.
He told members of the committee that efficiency savings, reform and modernisation initiatives were taking place in the context of increased day case surgery, outpatient attendance and A&E services.
"Given the increasing demand, meeting our CSR savings is a difficult challenge, and, in my 35 years in health and social care, I have not experienced challenges as significant as the ones that we are facing now. That is an explanation of the situation on our performance to date and on the outstanding issues," said Mr Lusby.
Mr Alan Corry-Finn, Director of Primary Care and Older people and the Executive Director of Nursing also told the committee of the stark reality faced by health chiefs charged with delivering services on a tighter budget.
Asked by West Tyrone MLA, Dr Kieran Deeney why four directors of finance and four directors of nursing are needed for 300,000 patients, in the Western Trust, Mr Corry-Finn said managers were thinner on the ground in this area than anywhere else in Northern Ireland.
"Like Joe, I have worked in the Health Service for 35 years, 32 of which were spent in the east. Given the number of managers and leaders in the Western Trust, it is the leanest place in which I have ever worked," said Mr Corry-Finn.
"We aim to ensure that the right people are employed in posts in the first place, that they are educated and developed and that we develop policies and strategies to support front-line staff.
"Moreover, we aim to develop practice and a culture of enquiry so that sound governance arrangements exist throughout the trust. Our focus is to provide safe, effective, high-quality patient care; the assistant directors and I are committed to that. That is how we spend our time," he added.
During a questions and answers session at Stormont it also emerged that whilst £36.2million in investment has been promised to the WHSCT if it delivers £36million of efficiency savings during the 2008 and 2011 CSR period, there has been a shortfall in investment this year.
Chief Executive of the Trust, Elaine Way, stated: "I particularly draw the Committee's attention to that fact all the trusts are experiencing significant financial pressures in 2009-2010 because of the way in which the investment has been arranged.
"That system means that the Western Trust has had to make £12·1million in efficiency savings and has received only £5·4 million in investment, leaving it with a net decrease of £6·7 million."
It also emerged that 48 efficiency savings originally proposed across all WHSCT departments in 2008 would not be enough. Alternative savings proposals are being considered.
These include a regional replacement of X-ray films with digital technology that could save the Trust £300,000 and a skills mix review of nursing and health staff that could save £14,000.
Full details of the Trust's CSR can be read on the Northern Ireland Assembly website under: Evidence Session on Comprehensive Spending Review Efficiency Savings with the Western Health and Social Care Trust, October 22, 2009.