The region's troubled mental health trust has been warned it is "walking a tightrope" financially - as it scrambles to make millions in savings to balance its books.
The Norfolk and Suffolk NHS Foundation Trust is facing a black hole in its budget of more than £17m, which it needs to address by next April.
The organisation, which provides specialist mental health care in Norfolk and Suffolk, has been told it needs to shave £17.4m from its running costs to meet its 'efficiency target'.
And campaigners fear that its care, which has already been told it needs to improve, will suffer as a result of the need to make budget cuts.
During a meeting of the trust's board of directors, it was warned the financial position is precarious.
Adrian Matthews, a non-executive director for NSFT, said: "This is a particularly difficult period for us, as it is for the whole system and the NHS itself.
"We are walking a tightrope."
Jason Hollidge, chief finance officer at NSFT, added: "If we do not do anything, we will be moving into a deficit by the financial year's end."
Zoe Billingham, the trust's chairman, added that the situation needed to be treated as a "loud alarm bell" for the organisation.
He added that the position would be eased if a VAT refund from the cost of its new £55m Rivers Centre development at Hellesdon Hospital is received before the end of the year.
Mark Harrison, chairman of the Campaign to Save Mental Health Services in Norfolk and Suffolk said the group feared any cuts would have a detrimental effect on frontline services.
Mark Harrison, from the Campaign to Save Mental Health Services in Norfolk and Suffolk (Image: Newsquest)
He said: "We are especially worried that the trust is going to have to make £17m of savings.
"In the past, these cuts have been contributory to the failings people have experienced and so our confidence in improvements is dampened knowing the impact efficiency cuts can have."
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