Toby Lewis Chairman of the Trust said Balfour Beatty and its inhouse M&E specialist Balfour Beatty Kilpatrick were now waiting in the wings with their wider supply chain ready to mobilise.

The Trust revealed it had still not reached final agreement in board minutes ahead of a meeting today despite gaining Government approval for £350m of public funding to complete the hospital over two months ago.

The signing off of a contract has been held up because of a funding gap between the agreed final business case for Midland Met and central NHS improvement targets imposed just after sign-off.

Lewis said: “We are close to reaching commercial close for the Midland Metropolitan with Balfour Beatty, and when we do, we have also secured our facilities management supplier.”

Lewis said the NHS board and Balfour had agreed risk transfer for MEP would sit with Balfour.

He added: “Considerable time during November has been focused on moving forward with the Midland Metropolitan.

“At the end of November, we agreed and both signed a memorandum of understanding with Balfour Beatty which confirmed that the majority of material matters consistent with start on site in December 2019 are now concluded.”

But he warned: “As outlined in the board’s last public meeting, we have to resolve the discrepancy between the agreed final business case for Midland Met and NHSI/E’s financial improvement trajectories issued in the days shortly after approval.

“It will not be possible to proceed nor sign a contract until that discrepancy is resolved.”

Lewis said the Trust had being trying to resolve the block for six weeks with national officials.

While the Trust has missed sign-off deadlines for October 31st and then November 30th, he said there were no obvious reasons why it could not be able to achieve contract signature in the next two weeks.