A major acute hospital in the East of England and its main commissioner are to go to mediation after being unable to sign a contract for this financial year.

NHS Norfolk and Waveney has asked the Centre for Effective Dispute Resolution to step in after it could not reach agreement with Norfolk and Norwich University Hospitals Foundation Trust over two elements of the proposed contract.

At issue are how quickly the trust can start to achieve an 18 week referral to treatment time for orthopaedic patients and how it should be penalised for missing this. There is also disagreement about what penalties the hospital should face when ambulance turnaround is delayed.

The primary care trust cluster’s board papers reveal it and the trust had been in dispute over when the 18 week standard should be reached.

Norfolk and Norwich originally suggested the end of February 2013, with penalties then only applying if it failed to meet the standard for two consecutive months. The cluster rejected this.

The trust then offered achievement by the end of December this year but with penalties still not being applied until it had failed to meet the target for two successive months. This was also rejected.

The dispute over ambulance turnaround times occurs with under half of the ambulances being released within 15 minutes over the last two months.

The trust, cluster and ambulance service have discussed a tripartite agreement setting a target of 80 per cent being released within 15 minutes with penalties of £70 per hour for waits over 15 minutes. However, the trust rejected penalties for failure to meet the 80 per cent target.

The date and cost of mediation are not yet known.