Health chiefs are facing a crunch five weeks when it comes to achieving a massive £530 million savings plan for Lancashire and South Cumbria.
NHS leaders agreed a plan in June which would see them work towards a £175m deficit for the neighbouring areas.
This would mean Lancashire and South Cumbria Integrated Care Board (ICB), which manages systems, to find cuts of £270m, and NHS hospital trust providers, such as East Lancashire's, to recoup £260.8m.
Currently, ICB bosses say the savings plan is 'on track' - but board members have been told September and October will be crucial when it comes to ensuring the overall proposals come to fruition.
Dr Sakthi Karunanithi, Lancashire's public health director, asked a board meeting what would happen if the health system did not start to "see the benefits" of the savings plans after this period.
"It gives us five weeks and we are being told that this is the only option," said Dr Karunanithi.
"How confident are we this is going to actually be pulled off?"
He also asked what the consequences would be for the health system if the plans were not achieved.
Sam Proffitt, the ICB's chief finance officer and deputy chief executive, had told board members that tackling escalation costs generated by the urgent and emergency care pathway, representing around £80m, would be a key factor.
This included issues around 'corridor care', escalation beds and delayed discharges, the meeting heard.
Responding to Dr Karunanithi's concerns, she added: "All of our providers are totally committed (to this) and are working on these plans but it is a very challenging situation.
"It is not an unachievable plan but it has a very high amount of risks with it."
She told the board if the savings were not delivered then, in line with other ICB organisations, there was the possibility of the NHS implementing 'special undertakings' to address financial matters.
The ICB has been working recently with PA Consulting to "stress test" savings proposals and receiving support, alongside other boards, from NHS England.
Board members ratified a five-year urgent and emergency care strategy designed to tackle pressures on the frontline providers.
Earlier this year the Lancashire Telegraph reported how the ICB was working towards 'zero' corridor care days across Lancashire and South Cumbria.
It was also reported an average of 68 patients were left waiting for admission on hospital corridors at the Royal Blackburn Hospital - and probes were ongoing into two deaths said to be the result of 'poor care'.
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