The severe financial deficit at St George's Hospital is getting worse, despite a major drive by NHS managers to slash costs.

The trust has even suspended paying its debts to other NHS bodies in order to balance its books from month to month.

Finance director Colin Gentile and his hospital trust board colleagues have implemented a range of cost-cutting measures but they have not plugged the hole and he has said St George's cannot do it alone.

Instead of reporting progress on cutting the Tooting hospital's projected £20million shortfall, Mr Gentile this month predicted a year-end deficit of £21.5million because of "outstanding risks and worsening trends".

The news comes just weeks after the Prime Minister visited and praised the hospital.

Managers have successfully cut costs in cardiac services and eliminated many costly vacancies and the use of expensive agency staff, but they have faced new costs in Accident and Emergency, essential maintenance and soaring wage bills particularly thanks to a new consultants contract.

Money should have been saved on the closure of 26 beds earlier this year, but the debacle over fire safety at the Bolingbroke Hospital meant some had to be reopened to care for transferred geriatric patients.

The cash crisis led the trust to borrow £11million, but that must be paid back by March 31, and a further temporary loan of around £10million will not be enough to cover the trust's debts.

Mr Gentile reported "emergency measures" already implemented included suspending payments to major NHS creditors.

That includes £1.6million owed to the NHS's litigation authority, which has responded by saying it will not cover the costs of any legal settlement the hospital incurs.

One bright development is an underspend of £2.5million in the trust's capital spending, meaning that cash can help ease the deficit.

But Mr Gentile has repeatedly said St George's budgetary problems cannot be solved without help from other health bodies, particularly the regional Strategic Health Authority (SHA) and the Wandsworth Primary Care Trust (PCT).

The SHA has said any growth in the PCT's budget should first go towards the St George's deficit, but with the PCT facing its own troubles that is likely to face opposition.

But Mr Gentile warned that St George's should be seen as a priority, saying: "The trust has real liquidity problems of a magnitude that requires external support."

gmcgregor@london.newsquest.co.uk