West Hertfordshire Hospitals NHS Trust faces a crippling shortfall of £124 million in eight years unless drastic action is taken to turn its financial performance around.
Meanwhile hospital bosses in charge of Watford General estimate it will cost upwards of £350 million to bring the trust’s ageing estate up to task.
It has emerged they are now seeking £45.7 million of government cash in a bid to curb its spiralling deficit - which is set to double by the end of the year.
Trust chiefs initially reported a revenue deficit of £14 million in April, but following a meeting with the government’s NHS Trust Development Authority (TDA) it is set to revise the debt to £29.5 million.
A report presented to the board this month said: "Following review and meetings with the Trust Development Authority, revised proposals have been prepared that better reflect the contractual position with the trust’s commissioners and include transformation costs that the trust envisage are an essential step in creating a financial viable trust."
It continued: "As a result the forecast outturn and control target against which the Trust would wish to be measured has been revised to a deficit of £29.5m."
In the new business plan, the trust’s finance experts said it would cost approximately £350 million to modernise its buildings in a way that "supports efficient patient care and minimises health and safety risks".
In addition to going cap in hand to the government for more cash, the trust outlined plans to make savings totalling £71.2 million between now and the end of the 2019 financial year.
However, the increased emergency activity the hospitals have seen recently is expected to get worse in the coming years.
And the trust must also find the funds to carry out millions of pounds worth of maintenance backlog to their buildings and electrical systems - in 2009 that work was estimated to cost £66 million.
Mariane Covington, spokeswoman for the trust, said revising the deficit would better reflect the trust’s financial challenges.
She said: "As a trust, we are modelling scenarios which could see our deficit increase to better reflect the challenges we face, including a further rise in the number of emergency patients we are treating and essential spending to further improve the care we provide to our patients.
"Our planned deficit remains at £14 million until any change has been agreed with the appropriate body."