Health bosses are preparing for a bleak winter of snow, industrial action, and a financial backlog.

East Cheshire NHS Trust, which runs Macclesfield Hospital, has £167 million a year to spend and planned to make a surplus of £250,000 this financial year.

At last week’s board meeting the trust reported breaking even this month with a small surplus of £4,000 – but is £269,000 behind plan.

The trust is off-target after being penalised for failing to treat enough patients within 18 weeks of referral, and after losing money for treating patients readmitted to hospital within 30 days of discharge.

The trust’s backlog is due to last year’s harsh winter and it is planning again for the worst – with a prediction of snow at the end of the month. It is still working on its merger with Cheshire East Community Health and expects industrial action across the NHS later this year.

Chairman Lynn McGill said:  “It’s some assurance that we have broken even at month five, but we are trying to integrate two organisations and balance the books, all in a difficult climate.

“There is a lot of work being done but still a lot to do in a short space of time.”

Winter pressures include flu, the effect on the elderly and vulnerable in extreme weather, and a reduced workforce if staff are sick.

Plans include providing extra beds, redistribution of staff to meet demand, around-the-clock radiographic staff, flu campaigns and immunisation for staff and vulnerable patients which starts this month.

Kath Senior, director of nursing, performance and quality, said lessons have been learned.

She said: “Robust winter planning is in place to provide effective, safe care while maintaining 18 weeks.

“It’s taken six months to recover 18 weeks and we don’t want to be there again.

“We have to prepare for the worst.”

But it wasn’t all doom and gloom at the trust’s AGM.

Chief executive John Wilbraham listed achievements which included an average of 90 per cent for targets by the Stroke Team, such as CT scans within 24 hours. Mrs McGill said: “We punch well above our weight.”