Health bosses in the north-east of England are fighting to claw back a financial deficit of more than £63m.
The trust has made £30m of savings in the last year
A BBC News website survey of NHS trusts found many face deficits and describe severe financial challenges ahead.
They said pressures include energy and drug costs and pay arrangements under the Agenda for Change programme.
But they add the deficits are relative to budgets of tens or hundreds of millions of pounds and many expect to break even by the end of March.
South Tees Hospitals NHS Trust, which runs the James Cook University Hospital in Middlesbrough, the Friarage Hospital in Northallerton, and Guisborough Maternity Unit, is in the most serious position.
So far this year it is running a deficit of £3.75m and is forecasting a break-even position. But an overspend of £21m from last year has had to be carried over. The Trust's total budget is £326m.
The trust said it is taking the situation "extremely seriously"
The trust set up a recovery plan nearly a year ago and this has resulted in £30m of savings. Measures include a recruitment freeze, a small number of redundancies, natural wastage and a review of housekeeping with areas like stationery and catering.
Director of finance Wendy Hull said: "We have always been clear and very open about the seriousness and gravity of our financial position and are now taking real action to address the issues facing this trust."
North Tees and Hartlepool NHS Trust reported a deficit of £11.6m in November on a budget of £180m, a situation it says it is taking "extremely seriously".
It said it is finalising a business recovery plan to get it back into financial balance in the next two to three years with measures already introduced including a vacancy freeze and restriction on non-essential expenditure.
Hartlepool Primary Care Trust brought a legacy deficit of £4m into this financial year and said while the overspend will remain it is set to achieve a break-even position at the end of March.
Sedgefield Primary Care Trust had a £3.8m overspend at the end of November and Gateshead Primary Care Trust's position at the end of October was a £2.65m overspend but with a financial plan to achieve a balanced out turn.
Newcastle upon Tyne Hospitals NHS Trust's position for December, was a deficit of £2.3m on its turnover of £550m with an anticipated break-even position in March.
Newcastle upon Tyne Hospitals NHS Trust chief executive Len Fenwick said it was a dynamic situation with day to day changes.
He compared the act of balancing the books of a multi-million pound trust with "landing a jumbo jet on a postage stamp".