Bosses at New Cross Hospital will have to claw back £28million in savings this year in a bid to meet Government targets.
The trust fell almost £13m short of its target during the last financial year, which is being carried over to 2014/15.
Finance chiefs said the shortfall was a ‘significant issue’.
This time last year the trust carried over £6m to its 2013/14 budget.
But bosses have desperately struggled to find the required savings and so £12.9m will carry forward to next year's savings programme.
It will put ever-increasing pressure on an already tight budget.
And it comes at bosses prepare to fork out £30m for a new Emergency Centre, which is due to open in November 2015.
The centre, which includes a much-needed new A&E unit, a walk-in centre and other primary care services, will revolutionise the hospital's emergency care.
But it comes at a cost - taking into account extra equipment it will eventually cost £40m, more than a third of the trust's five year budget will be spent on the centre.
In total the trust’s expenditure budget between now and 2019 is £95.6m.
Of next year's extra budget savings, which form part of the trust's Change in Programme (CIP) plan, contracting chief Maxine Espley spelled out the risks being put on the trust's finances.
In a report to board members she said: "In summary, at the year end 76 per cent of the (2013/14) annual target has been achieved, but only 39.6 per cent has been achieved recurrently.
"This carries forward into 2014/15 a high level of risk.
"The carry forward of £12.9m will be added to the 2014/15 target of £15.3m, to give a required level of CIP in 2014/15 of £28.2m.
"This is a significant issue for the trust."
All NHS trusts and foundation trusts must save of four per cent of their budget each year as part of stringent savings outlined by the Government.
For the Royal Wolverhampton NHS Trust this equates to £15.3m for the 2014/15 financial year.
The full details of how the £28m will be saved have not yet been finalised.
But it will include a reduction in treatment wastage, improving turnaround times for patients and reducing patients' length of stays.
Chiefs have previously said the investment was part of a long term ‘masterplan’ and would not impact on other vital hospital services.
At first £28m is being spent on building the emergency centre, of which £2.9m has already gone on design costs and initial building work in the current financial year.
A further £12.5m – labelled phases two and three – will see extra beds gradually added into the centre once it has opened.Subscribe to our Newsletter