An emergency meeting is to be held by NHS Borders to look at ways to find savings of £45m over the next three years.
Closures, a recruitment freeze and reductions in service will all be considered.
The meeting will take place on 19 February with a final spending plan to be submitted to the Scottish government before the end of March.
NHS Borders chief executive Ralph Roberts said it was important to be up front with the public about the challenges being faced.
He said there was bound to be an impact on services.
“Upwards of 10% of our budget is really what we are talking about needing to take out,” he said.
“You cannot do that without there being an impact on the level of service that we are providing.
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