Blog: These are not happy times for the bosses of the trust which runs the Royal Shrewsbury Hospital and Telford’s Princess Royal, writes health correspondent Dave Morris.

They are currently facing a strong, and growing, protest over proposals to move women and children’s services from Shrewsbury to Telford.

And now the trust has been struck by what chief executive Adam Cairns describes as the “perfect financial storm” which is costing it millions of pounds.

It has been created by a big rise in emergency admissions – far above the numbers the trust had contracted for with its service “paymasters”, the primary care trusts.

For every patient it treats above its contract level, the hospital trust gets paid only 30 per cent the cost.

What a crazy state of affairs.

On this occasion, my sympathy lies with the trust.

What is it supposed to do when far more patients than it expected are referred to the two hospitals as emergencies? Close the doors?

And when far more people are being brought by ambulance to the A&E units than had been planned for in the contract, what is it supposed to do? Turn the ambulances back?

The “perfect storm” is also whipped up by the fact that a big rise in emergencies results in bed shortages, and routine operations have to be cancelled, which costs even more money.

And on top of all this trust has run up a “big bill” in staff costs as a result of all the extra work.

Mr Cairns is looking forward to having a “constructive dialogue” with colleagues at the primary care trusts.

I for one wish him well.

But why are patient numbers so high?

It’s a fact that the Shrewsbury and Telford hospitals have come through an extremely busy time, dealing with flu cases and other winter illnesses.

But the pressure on services always appears to be high.

Have people’s expectations risen? Are they more demanding? Does the problem stem from an ageing population? Are GPs “playing safe” in this compensation-seeking age and referring more patients to hospital?

I really don’t know.

And yet I frequently attend meetings, both council and NHS, at which “preventative” initiatives, aimed at cutting hospital admissions, are discussed and approved.

In the meantime the “perfect financial storm” shows no signs of calming.