By agreeing to extend the minimum period of the contract by five years to 2037 the Trust accepted the risk that it would be committed to paying for services under the contract over a longer period. This was despite the fact that changing patterns of clinical provision make it impossible to predict, that far in advance, the nature and extent of the services that may be needed. In some situations, such as the current initiative to provide clinical care in the community rather than in hospitals, the demand for certain hospital services can reduce. The Trust acknowledged, however, that, if it were in deficit, it would not be able to reduce what it would pay for the hospital building and its maintenance but could only make savings in ways which would affect its capacity to provide clinical services. There might be scope for savings by reducing the other services provided by Octagon such as porters, catering and cleaning but the Trust would have to reduce its clinical capacity to achieve these savings.11
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11 C&AG's Report, para 2 and Figure 24, p22; Qq 84-89, 115-116