ɪn noʊvˈɛmbɚ ðə tɹˈʌst ɐnˈaʊnst ðˌɐɾɪt hæd ɹᵻfjˈuːzd tə sˈaɪn ðə kˈɑːntɹækt bɪkˈʌz ɪɾ ɛndˈeɪndʒɚd ðə vˌaɪəbˈɪlᵻɾi ʌv ɪts tɹˈɔːmə ænd ˈæksɪdənt ænd ɪmˈɜːdʒənsi sˈɜːvɪs æz ðə nˈʌmbɚɹ ʌv ɹᵻfˈɜːɹəlz dɹˈɑːpt baɪ θˈɜːɾi pɚsˈɛnt.
In November the Trust announced that it had refused to sign the contract because it endangered the viability of its trauma and Accident and Emergency service as the number of referrals dropped by 30%.