Cash-crisis trust puts patients on a fast track home.
Birmingham Heartlands and Solihull NHS Trust has been ordered to save pounds 5 million on its pounds 178 million annual budget.
The savings have to be made as part of a Government efficiency drive and are to be ploughed back into GP services.
But trust managers claim that the abolition of GP fundholding has made their task even harder.
The trust chief executive Mr Robert Naylor told its annual meeting: "This year financially has probably been the most difficult year we have had.
"The pressures have been enormous.
"In the past we have been allowed to use some of the money we save but now it is being recycled into the development of primary care.
"We feel that the level of funding should be maintained in trusts like this while additional money should be put into primary care.
"Only when it can be demonstrated that primary care can take some of the burden from us should the money be taken away."
Mr Naylor said changes in the GP system had caused problems because in the past the trust had balanced its books by taking on additional work from GP fundholders. This was not now possible.
He said the trust was making savings by reducing the length of time that patients stayed in hospital and increasing the proportion of patients who were treated and returned home on the same day.
The director of surgery Mr Mark Goldman said the trust was deploying teams of nurses to go to patients' homes after they left hospital.
He said: "Patients who have had operations often stay in hospital for the sake of things such as having dressings changed.
"We can now send them home and a nurse will go to their home and change their dressing or perhaps remove a shunt from a patient who has had breast surgery.
"This is proving particularly successful for women who have had hysterectomies."
Mr Naylor said the trust was also facing increasing difficulty in keeping waiting lists down because of a 20 per cent increase in referrals from GPs.
He said the abolition of GP fundholding seemed to have played a part in this - since GPs no longer had to worry about the cost of sending someone for a hospital check-up.
The meeting was the last chaired by the former Rover boss Mr Harold Musgrove.
Mr Musgrove is expected to take over the chairmanship of a new Worcestershire hospitals trust when it is created next year. His successor is to be public relations specialist Mr Paul Castle.