NHS chiefs have increased the pressure on cash-strapped health bosses in the region.

NHS chief executive Sir Nigel Crisp has asked senior managers at over-spending trusts to take urgent action to stop the rot.

His announcement follows the publication of a list of trusts that finished the last financial year in the red.

Among them - but not the worst - were South Tees Hospitals NHS Trust (£8.8m in the red), Scarborough and North-East Yorkshire NHS Trust (£4.5m) and Selby and York Primary Care Trust (£6.5m).

Sir Nigel said investment in the NHS was at record levels.

By 2008, annual expenditure on the health service is expected to reach £90bn.

"The final audited accounts for 2004/5 show a net deficit for the NHS as a whole of around £250m," said Sir Nigel.

"The great majority of NHS organisations were in surplus or balance.

"This overspend is a tiny proportion - 0.4 per cent - of the total NHS budget of £69.7bn.

"We need to take it very seriously and to ensure that all NHS organisations manage their finances well."

The hospital trust with the largest deficit is the Surrey and Sussex Healthcare NHS Trust (£30.6m).

The primary care trust most in debt is Kensington and Chelsea PCT (£17.9m).

South Tees Hospitals NHS Trust, which includes the 1,000- bed James Cook University Hospital, Middlesbrough, and the Friarage Hospital, in Northallerton, North Yorkshire, has undergone tremendous expansion in recent years and is struggling to balance income with expenditure.

South Tees chief executive Simon Pleydell said: "The board has always been clear - and open - about the seriousness of the problem and a two-year recovery plan is in place to restore financial balance on an annual basis by the end of 2006/07."

Bernard Flynn, director of finance at the Scarborough trust, said: "We have agreed a three year recovery plan with the Strategic Health Authority, which includes a number of actions to reduce costs and increase income.

"This also takes into account the additional funding that the trust will receive as a consequence of the new 'Payment By Results' financial system."

A spokesman for Selby and York PCT said: "A new chief executive and director of dinance have been appointed and are currently reviewing all aspects of the trust's business."