PERFORMANCE: University College London Hospitals has warned it may have to consider “curtailing access to services” if NHS England is “unwilling to agree contract volumes” for the foundation trust’s specialist services.

The warning comes just weeks after HSJ reported that UCLH and NHS England had failed to reach agreement over £75m worth of the trust’s specialist services contract for 2014-15.

The trust this month revealed that 93 patients have been on its waiting list for more than a year, of which 75 people require specialist treatment.

In a frank report to the trust’s July board meeting chief executive Robert Naylor said it was important to “expose this issue in the public domain”.

Sir Robert said a number of UCLH’s longer waiters were for the “most highly specialised services” which were “not always funded or commissioned by [NHS England].”

He added that commissioners had turned down investment proposals by the trust to expand the specialist services in greatest demand.

A spokeswoman for UCLH said: “The trust is not currently considering curtailing access to services, although it may need to consider this if commissioners are unwilling to agree contract volumes particularly in specialist services where the trust is one of only a few providers in the NHS.”

The trust’s waiting list has grown by 28 per cent since last year.

Sir Robert told the board: “To put this all in perspective, we currently have 4,677 patients waiting over 18 weeks, the majority of whom are waiting for a non-urgent outpatient appointment.

“In addition we have 93 patients waiting over 52 weeks, the majority of appointments are for highly specialised services at [the National Hospital for Neurology and Neurosurgery] Queen Square.”

The trust has told Monitor it is likely to continue to fail referral to treatment targets “until we can identify additional capacity…and secure agreement from commissioners to fund the cost of these additional patients”.

Sir Robert said that the trust would need to “reconsider how it might be able to increase capacity or alternatively reduce demand by curtailing access to a number of our services”.

He continued: “This discussion could be accelerated by the current contract negotiations with [NHS England] where there is a clear strategy to reduce patient activity to meet financial constraints of the specialist commissioning budget.”

An NHS England (London) spokeswoman said the two organisations “remain committed” to agreeing the specialised contract. She continued: “As part of these negotiations, NHS England is investing further funding to reflect the priority areas of growth identified.”

NHS England has “already signalled that additional investment will be made to treat these patients once the validation process has been concluded”, she added.