Health and social services boards in Northern Ireland have been told to delay new developments in case money has to be diverted to meet a shortfall of up to£20m for this year's pay awards.
Department of Health and Social Services chief executive Paul Simpson wrote to boards saying that all trusts and boards are being surveyed to determine the extent of pay pressures on them.
He added: 'In the meantime, I would advise you not to enter into any further commitments for the use of development funds.'
Mr Simpson has now written again to trusts for clarification of their returns. A decision is not expected before the end of the month.
The letter came as most boards were about to confirm new developments in response to previous advice to set aside some of this year's allocation for additional services.
Trusts and boards in Northern Ireland were notified of their funding at the beginning of the year - before the pay awards were announced. It included 2.6 per cent for inflation to cover pay awards - but these turned out to be around 4 per cent.
All four boards are pressing the DHSS to fully fund the pay awards to avoid losing much needed improvements to services.
Southern board was about to commit£8m to developments, ranging from improvements to children's cancer services to a£2.15m care programme for older people, when the letter arrived.
It decided to confirm its commitment to the developments and to call a special meeting to consider next steps once the DHSS announces its position.
'This could have a huge effect,' a spokesperson said. 'There was talk of a lot more money for us, but all that has happened is that it has been taken away again by a different hand.'
Northern board is due to meet today to discuss its position. Chief executive Stuart McDonnell said the deficit between the board's funding and the pay award was a 'minimum of£4m-5m'.
Taken with the other three boards' likely deficit, that could mean the total shortfall throughout Northern Ireland could be as much as£16m-20m.
A Northern Ireland Office spokesperson said: 'As in Great Britain, Northern Ireland faces a number of pay pressures.
'We are currently assessing the extent of them and are keeping our options open on how any possible shortfall will be met.'