Shropshire's largest two hospitals are being loaned millions of pounds to help deal with debts.
The trust has 5,000 staff over two main sites in Shropshire
They will clear a long-term debt of £31.4m owed by the Shrewsbury and Telford Hospital NHS Trust, plus a further £2.8m deficit for this year.
Chief executive Tom Taylor said the money has been borrowed at 4.5% from NHS trusts which have surpluses.
A review of services is underway with an announcement on 10 July starting off a consultation about potential cuts.
The Royal Shrewsbury and Princess Royal, Telford, hospitals combined their trusts in 2003 and a new board was set up in August last year.
Debts are supposed to be repaid within five years but the trust is asking for a further extension from the implied 2008 deadline.
The plan is to start repayments in the 2006-07 financial year with all money repaid by 2012.
Mr Taylor told BBC News that overspends in the first half of last year totalled £8.2m and it hit two out of six patient targets.
But the second half of the year saw all targets hit and the deficit trimmed to £3.9m.
Primary care trusts have contributed their surplus money to the NHS bank which then loans money to struggling trusts.