• £14.4bn of £15bn specialised services contracts agreed but only half have been signed
  • Two trusts considering arbitration over £7m deal and another 10 trusts have not agreed contracts
  • Providers pushing for £13m over the budget

NHS England has agreed £14.4bn worth of the £15bn specialised commissioning contracts for 2017-18.

The national commissioning body has signed just over half of the 285 separate contracts, however agreements are in place for 90 per cent of contracts.

This leaves £600m in specialised commissioning budget still being disputed with trusts providing specialist services.

NHS England confirmed yesterday this figure was split between two trusts that had indicated they were considering arbitration and another 10 which had not agreed contracts. £7m in spending relates to the trusts in potential arbitration, which NHS England would not identify. The other £593m comes from the 10 which have not agreed a contract but they are not expected to go to arbitration.

NHS England would not confirm which trusts were considering arbitration but said of the 12 that had not agreed contracts: seven were in the north, two in the Midlands and East region, and four were in the south.

London, which has a high concentration of specialist providers and a 2017-18 specialised commissioning budget of £3.9bn, has agreed all its contracts.

Arbitration has to be for a contract dispute of £1m or more and foundation trusts are not obligated to participate in the process, which involves regional officials from NHS England and NHS Improvement making a decision. If this cannot be agreed, the matter is referred to an independent panel. For the 2016-17 contracting round seven regional panels and six independent panels were convened, up from seven regional panels in 2015-16.

The deadline for signing contracts was 23 December and if the three arbitration cases go ahead the regional panels will meet on 23 January.

This marks a significant improvement on last year, with contracts deadlines brought forward by three months.

London’s specialist services have agreed to make savings of 2.5 per cent year on year in 2017-18, totalling £95m.

In 2015-16, the 10 biggest providers of specialised services had a combined income from NHS England of £3.5bn – 27.1 per cent of the total and down from 27.7 per cent in 2014-15.

NHS England is looking to centralise specialised work in fewer centres.