The Midland Metropolitan University Hospital in Smethwick, had originally been due to open in 2018, but hospital chiefs have admitted that plans for it to open next year now looked 'increasingly unlikely'.
The trust has blamed a lack of building materials and construction workers for the latest delay.
New fire regulations relating to the external facade are also said to have contributed.
The hospital's original opening date was delayed by the collapse of the previous contractors, Carillion.
After appointing Balfour Beatty to replace Carillion, Sandwell and West Birmingham Hospitals Trust planned to open the new hospital by 2022.
But the trust board has now been told that this date is unlikely to be met.
Trust director Rachel Barlow said she hoped the trust would be in a position to confirm an opening date by the end of the year.
She said: “It is becoming increasingly unlikely that we will be able to open the hospital in 2022.
“The impact on the construction industry on the available workforce and required materials are well known and are a live risk which is being actively managed.
“Additionally, we have responded to the new fire regulations with a requirement to replace parts of the external façade that has had an impact on the programme.”
She said construction on the building had progressed well during the pandemic.
But she added: "There have inevitably been some significant impacts over the past 18 months relating to supplies, workforce availability and replacement of part of the external façade due to changed fire regulations.”
The plan, which was first put forward a decade ago, will see the trust relocate acute services from Sandwell General and Birmingham City Hospital.
The project was listed as the first within the government’s flagship programme for 40 new hospitals, although there was criticism of its inclusion on the list, given it was already under construction at the time of announcement.
A spokeswoman from Balfour Beatty said: “We continue to work closely with the trust to ensure the successful completion of this landmark project.”
A report published by the National Audit office last year estimated the original four-year delay would increase building costs from £688 million to almost £1billion.
It is not known what impact the latest delay will have on the budget.