Sheffield hospital bosses have rejected a revised Government offer on budget cuts for next year.
Health chiefs revealed back in January they were facing the prospect of finding more than £40m in savings from April.
But uncertainty remains on the precise level of cuts following a national revolt by NHS trusts against Government proposals to change how services are funded.
A revised offer by the Government has now been rejected in Sheffield - sending parties back to the negotiating table.
Details have been a report going to a board meeting of the Sheffield Teaching Hospitals NHS Foundation Trust this week.
Neil Priestley, director of finance, said departments are preparing plans for potential cuts that will be submitted towards the end of this month.
But he added ‘uncertainty’ remains about precisely how large the cuts will be.
In February, health watchdog Monitor and NHS England offered a revised deal to NHS trusts after more than 75 per cent rejected original proposals.
Trusts were given the option of either accepting new terms or taking the 2014/15 rates - but on the condition they would not receive Commissioning for Quality and Innovation funding.
Mr Priestley said: “Both options leave the Trust with a significant deficit.
“The Trust has therefore, along with a significant number of other major providers of specialised services expressed its dissatisfaction with both options and asked for further consideration of the position.”