NHS trusts across the country are making cuts as the health service is gripped by a financial crisis.
But it is not always bad management and financial difficulties that are the cause.
A top-performing trust in Oxfordshire, which has been balancing its books for years, is having to make savings to help out its neighbouring NHS services.
In many ways Oxfordshire's mental health service is a victim of its own success.
For the last five years the trust has broken even, but that does not mean it has escaped the cuts being imposed across the NHS because of the financial crisis.
Last year, Orchard Lodge, a small inpatient unit in the north of the county for people with serious mental health problems such as schizophrenia, closed.
"The cuts will harm patient care and this is at a time when mental heath services need more investment not less"
Warneford and Littlemore hospitals in Oxford were left to pick up the demand for beds, but now those sites are facing the prospect of cuts.
The top three-star rated trust has been asked by local health bosses to make £5.5m of savings partly to bail out the rest of the county's NHS services.
Huge deficit
Oxfordshire is expected to finish the financial year over £25m in deficit.
Oxford Radcliffe Hospitals NHS Trust, one of the biggest trusts in the country, has a deficit of £5m due to factors such as increased fuel costs and patients remaining in hospital longer than necessary because there is nowhere suitable to discharge them to.
It is also absorbing £13.5m of the county's overall NHS debt.
As well as losing more of its inpatient beds, the mental health trust is also considering plans to shed seven psychiatric consultants and seven junior doctor posts.
This represents nearly a tenth of its clinical staff, although because of a forthcoming merger with a neighbouring trust no-one is likely to be made redundant.
A specialist A&E service for self-harm and suicide patients is also under threat.
The trust has responded by beefing up its community teams with a £1m centre opening up in the north of the county and patients being given 24-hour access to teams of psychiatric nurses, social workers and carers.
Vicky Lovell, a psychiatric nurse who has been helping to redesign the services, said: "For the last few years the push has been towards community services so we were heading in this direction already.
"People who would have ended up in an inpatient ward can now be cared for in their own homes and those who do go into hospital spend less time there. That is good for patients."
Lobbied against cuts
Nonetheless, trust chief executive Julie Waldron said officials had lobbied against the cuts, believing services needed investing in rather than trimming back.
But she added: "The truth is that there is only so much money to go round the county and we would rather see the region get into financial balance and then get extra investment in the future."
Not everyone is so philosophical. Patrick Taylor, director of Oxfordshire Mind mental health charity, said: "It seems bitterly unfair. The trust has been run well and now it is being punished.
"The cuts will harm patient care and this is at a time when mental heath services need more investment not less.
"Already the closure of Orchard Lodge has meant patients from the area have to be taken 50 miles away which is not good for them or their families."
Bad feeling
Jonathan Fielden, chairman of the area's consultants committee, agrees sharing the burden can cause problems.
"Antagonism can creep in between trusts and communication breaks down.
"But it has always been the case in the NHS that trusts share the burden.
"All trusts in the area are having to make savings to help out the Radcliffe. It could lead to hundreds of job cuts, wards being closed and operations delayed."
But the Oxford Radcliffe Trust says it is unfair to blame it for the measures being considered.
Over the last three years, the trust has been taking some drastic measures.
Some 300 posts have been shed form its 10,000 workforce, the deficit has been reduced down from £40m and services have become more efficient - under the NHS efficiency formula its care costs 6% less than the national average.
"Basically, there are more patients needing care than we have money to treat them. We can either turn patients away or treat them and go into deficit as we have done," said a trust spokeswoman.
"We have taken on the deficit for the county. Oxfordshire receives around £600m each year from the government. This is 15% less per head of the population than the average across the country."
Local MP Evan Harris is more categorical. The Liberal Democrat said the trust's hospitals were, like the rest of the NHS, victims of government interference.
"Because of waiting time targets, hospitals have not been able to manage patient lists and have had to treat non-urgent cases and therefore exceed what they have money for."
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