Missed targets for patients could end up costing the region's biggest hospital trust millions of pounds this year.

Bosses at the already cash-strapped Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) are negotiating with local health chiefs over how much it should pay in penalties after the financial year ends on Thursday.

The total amount of penalties, incurred by missing patient targets in areas such as A&E, cancer care and treatment waiting times, stands at £10m so far.

Sheila Budd, acting finance director of the trust, said it would be 'very worrying' if the fines were imposed.

A spokesman for Norfolk's clinical commissioning groups (CCGs), which buys services from hospitals on behalf of patients, said the value of the penalties are set nationally.

Money generated from fining hospitals is used to fund 'local health services on a case-by-case basis', meaning it is not necessarily reinvested back into where it came from.

In addition to the threat of a £10m fine, NNUH and the CCGs are also in dispute regarding the payment of £790,000 worth of services provided by the hospital.

Neither the trust nor the CCGs would comment on which services the dispute was over.

NNUH is aiming to end this financial year with a £14.4m deficit, the second consecutive year it will finish in the red.

Ms Budd said: 'The discussions with the CCGs on fines and penalties are ongoing and we would expect to reach a conclusion in early April.

'If fines were imposed this would be very worrying for our ongoing finances and our ability to fund future developments.'

A spokesman for North Norfolk CCG, which is the lead commissioner in Norfolk for acute hospitals, said: 'The contract between the Norfolk CCGs and NNUH is worth in excess of £280m per year and is governed by a set of complex national payment rules.

'There are inevitably a small number of queries about payments made under such a large contract – these total a very small percentage of the total value.

'The trust is currently working through these with the CCGs and we would expect to have resolved these over the next few weeks or so.'

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