Telford & Wrekin PCT was about to agree a budget for next year, having broken even for the current year, but has now been told to find an extra £6.5m.
Chief executive Simon Conolly said it is due to changing finances in the NHS.
This includes new national pricing structures and money being recovered from trusts to help balance NHS debts.
He said the new prices were costing the PCT £1.1m while the strategic health authority has asked for £5.3m back.
Mr Conolly said: "When recovering that sort of money you can't rule out there being some impact on patient care.
"We are certainly frustrated and it's a set back but we are part of the wider NHS and do want it to flourish.
"It will enevitably require a significant level of belt-tightening."
He said this will be worked out over the next four weeks.
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