Health

NHS health boards in Wales fail to balance books amid rising pressures

Published

5 months ago

August 29, 2024

A RECENT audit by the Auditor General has revealed that all seven health boards in Wales have failed to meet their statutory duty to break even over a three-year period, underscoring the growing financial pressures on the NHS. The findings, drawn from the 2023-24 accounts of NHS bodies, have sparked concerns about the sustainability of health services in Wales.

The audit, which provides a comprehensive overview of the financial health of NHS bodies, concluded that while the accounts present a true and fair view of their financial positions, the seven health boards were unable to achieve the statutory financial balance required by law. Consequently, the Auditor General was compelled to qualify his ‘regularity’ audit opinion for these health boards.

In contrast, the three NHS trusts and two special health authorities in Wales successfully met their break-even duties, offering a glimpse of hope in an otherwise challenging financial landscape.

Particularly concerning were the findings related to Betsi Cadwaladr University Health Board and Velindre NHS Trust. Both were found to have breached standing financial instructions, leading to irregular expenditure in payments made to former senior officials. For Betsi Cadwaladr, this marks the second consecutive year of such breaches, further highlighting the governance challenges faced by some NHS bodies.

The financial strain on the NHS in Wales is exacerbated by a combination of rising demand for services and the impact of inflation. In 2023-24, health services in Wales received £10.638 billion in revenue funding, an increase of £744 million from the previous year. However, despite this substantial cash uplift, the real-term increase in funding was just 1.2%, a modest improvement compared to the 4.9% real-term decrease in 2022-23.

The audit also highlighted a growing in-year deficit, which has risen to £183 million in 2023-24, up from £150 million in the previous year. The three-year cumulative overspend across the NHS has now reached £385 million, a significant increase from the £248 million recorded in 2022-23.

One area of concern is the expenditure on agency staff, which, despite a 19% reduction in 2023-24, remains a significant cost at £262 million. This spending largely covers workforce vacancies and additional activity to meet rising demand, underscoring the ongoing staffing challenges within the NHS.

In response to these financial pressures, NHS bodies have been striving to deliver significant savings. Reported savings for 2023-24 reached £210 million, the highest level since 2018-19. However, much of these savings are non-recurrent, with 41% of total reported savings falling into this category, down from 60% in the previous year.

The Auditor General, Adrian Crompton, expressed concern over the situation, stating, “The growing cumulative deficit for the NHS in Wales demonstrates that despite record levels of investment and higher than ever levels of savings, the statutory framework put in place by the Welsh Government to drive financial sustainability in the NHS is not working.”

Mr Crompton called for more fundamental changes to address the challenges faced by the NHS, including the need to reconsider its structure, funding, and workforce. He urged politicians, government officials, and NHS bodies to collaborate on finding sustainable solutions to these pressing issues.

As the NHS in Wales grapples with these financial challenges, the publication of the NHS Wales Finances Data Tool 2023-24 provides further insight into the current financial positions of NHS bodies, offering a valuable resource for those seeking to understand the complexities of healthcare funding in Wales.

Auditor General, Adrian Crompton told this newspaper: “Whilst I recognise the scale of the financial and operational challenges faced by the NHS, I am concerned at once again having to qualify my audit opinion on the accounts of all seven Health Boards because they have failed to meet the statutory duty to break even over three years. The growing cumulative deficit for the NHS in Wales demonstrates that despite record levels of investment and higher than ever levels of savings, the statutory framework put in place by the Welsh Government to drive financial sustainability in the NHS is not working.

Whilst there remains an urgent need for NHS bodies to continue to drive out cost inefficiencies in the way they work, this alone is unlikely to return the NHS to financial balance. More fundamental challenges now need to be grasped around the shape and infrastructure of the NHS, the level of funding it needs, its workforce challenges and how the demand for its services can be better managed. These are issues that should exercise the minds of politicians, government officials and NHS bodies and their partners in equal measure.’

The ongoing financial pressures and the inability of health boards to meet statutory obligations serve as a stark reminder of the urgent need for strategic planning and reform within the NHS to ensure its long-term viability.

Health

Hywel Dda Health Board announces Community Vaccination Centres

Published

2 days ago

January 28, 2025

Tom Sinclair

HYWEL Dda University Health Board is organizing pop-up community vaccine centres to make it easier for eligible individuals to access their flu and COVID-19 vaccines.

To check your eligibility for the flu and/or COVID-19 vaccine:

Visit: phw.nhs.wales
Contact the health board: 0300 303 8322 (Option 1)
Email: [email protected]

If you are eligible, you can either drop in at one of the centres listed below or book an appointment using the details above.

New clinics are being arranged for February. Stay updated by visiting the health board’s webpage:
Seasonal Flu Vaccinations

Vaccination Centres and Schedules

Carmarthenshire

Carmarthen Athletic RFC
Athletic Park, Johnstown, Carmarthen, SA31 3QY

Monday, January 27: 9:30am–4:45pm
Tuesday, January 28: 9:30am–4:45pm
Wednesday, January 29: 9:30am–4:45pm
Thursday, January 30: 9:30am–4:45pm

Llandeilo Fawr Civic Hall
17 Crescent Road, Llandeilo, SA19 6HW

Friday, January 31: 10:00am–4:45pm

Pontyberem Memorial Hall
Coalbrook Road, Pontyberem, Llanelli, SA15 5HU

Tuesday, February 4: 9:30am–4:30pm

Llandovery RFC
Church Bank Playing Fields, Llandovery, SA20 0BA

Thursday, February 6: 10:00am–4:30pm
Friday, February 7: 10:00am–4:30pm

Ceredigion

Tregaron Memorial Hall
The Square, Tregaron, SY25 6JL

Monday, January 27: 10:00am–4:30pm

New Quay Memorial Hall
Ffordd Towyn Road, New Quay, SA45 9QQ

Tuesday, January 28: 9:30am–4:45pm
Wednesday, January 29: 9:30am–4:45pm

The Pwerdy-Powerhouse Community Arts Centre
Chapel Street, Pont Tyweli, Llandysul, SA44 4AH

Tuesday, February 4: 10:00am–4:45pm
Wednesday, February 5: 10:00am–4:45pm

Pembrokeshire

Pembrokeshire Archives
Prendergast, Haverfordwest, SA61 2PE

Tuesday, January 28: 9:30am–4:50pm

Regency Hall
King George V Playing Fields, Milford Street, Saundersfoot, SA69 9NG

Friday, January 31: 9:30am–4:45pm

Neyland MVC
Unit 1, Honeyborough Retail Park, SA73 1SE

Monday, February 3: 9:30am–4:45pm
Wednesday, February 5: 9:30am–4:45pm

Llwyngwair Manor
Newport, Pembrokeshire, SA42 0LX

Thursday, February 6: 10:00am–4:30pm

Bloomfield House
Redstone Road, Narberth, SA67 7ES

Friday, February 7: 10:00am–4:45pm

Health

RCN demands urgent action and transparency on corridor care in Wales

Published

3 days ago

January 28, 2025

Tom Sinclair

THE RCN today issued a strong call to action to the Welsh government, urging them to take decisive steps to eradicate corridor care – a practice that is unsafe, undignified, and unsustainable. The most vulnerable in society, including many older people, bear the brunt of corridor care –where patients are treated in hallways and other inappropriate settings due to bed shortages.

Corridor care compromises patient safety and dignity by delaying timely treatment, reducing privacy, and increasing anxiety and stress. For the nursing workforce, it worsens workloads, contributes to burnout, and undermines their ability to provide quality care.

In open letters to the Welsh Government, NHS Wales, key watchdogs and advocates, the RCN has called for action on eight steps to end corridor care in Wales. The RCN’s eight recommendations include protecting patient safety and supporting the nursing profession by declaring care in chairs for over 24 hours a “never event” and fostering a culture where nursing staff can raise safety concerns without fear. Key steps include increase weekend staffing that can enable timely discharges, restoring District Nurse numbers to 2010 levels, and investing in social care to ensure patients can transition from hospitals to appropriate care settings promptly.

Additionally, the Government must pause hospital bed reductions and review capacity to ensure adequate care in both community and hospital settings. Investing in the nursing workforce and fully implementing the Six Goals for Urgent and Emergency Care programme is critical. NHS Wales must be empowered to divert patients to neighbouring services when necessary, easing pressure on overstretched facilities and improving outcomes.

Helen Whyley, Executive Director of RCN Wales, said: “Nurses are facing immense challenges in maintaining high standards of patient care amidst the growing prevalence of corridor and chair care in hospitals. The RCN’s recent report starkly highlights the stories of nurses who are striving to provide quality care in these difficult conditions. Despite the lack of proper facilities and the strain of overcrowded hospitals, nurses continue to demonstrate remarkable dedication and resilience. They often work long hours under intense pressure, ensuring that patients receive the best possible care even when resources are stretched thin.”

“Our recommendations provide a clear and achievable roadmap to ensure patients receive care in the right place, at the right time, and by the right professional. The nursing workforce is ready to lead the way – but we need the Welsh government to act now.”

The RCN is calling on the Welsh Government to engage all health care stakeholders, listen to the expertise of the nursing workforce, and prioritise patient safety above all else. The time to end corridor care is now.

Health

Leading pharmacies demand tougher regulation on online sale of weight-loss jabs

Published

4 days ago

January 27, 2025

Tom Sinclair

PHARMACIES are calling for stricter regulation of online sales of weight-loss injections, warning of risks to patient safety amid predictions of a surge in demand this year.

The National Pharmacy Association (NPA), representing independent community pharmacies, has urged the General Pharmaceutical Council (GPhC) to require more thorough consultations with patients before dispensing weight-loss injections and other high-risk medications online.

The NPA cautioned that existing regulations allow medicines to be supplied without adequate consultation or access to patient records, leaving patients vulnerable. They called for a mandatory two-way consultation process to ensure prescribers have a full understanding of patients’ medical histories before issuing such treatments.

Greater safeguards needed

Responding to draft GPhC guidelines, the NPA criticised the proposed safeguards, stating they “still leave the door open for medicines to be prescribed and supplied without appropriate two-way patient consultation or access to a full clinical picture, particularly with high-risk medicines.”

The association recommended prescribers engage in direct dialogue with patients—either in person or via telephone—before offering weight-loss medications such as Mounjaro injections. The NPA also stressed the importance of obtaining comprehensive medical histories, rather than relying solely on online questionnaires.

Nick Kaye, Chair of the National Pharmacy Association, said:
“Obesity is one of the biggest challenges facing our country, and pharmacies want to play their part in helping patients achieve and maintain a healthy weight.
“Weight-loss injections can be effective when prescribed as part of a carefully managed programme, but the current regulations allow some patients to access these medications inappropriately, without proper consultation or examination of medical records.”

Addressing rising demand

The call for tighter regulations comes as demand for weight-loss treatments is expected to rise, with the government planning to expand the rollout of such medications. Many pharmacies already dispense weight-loss treatments or include them in private weight-loss programmes, emphasising a need for best practices to prioritise patient safety.

The NPA highlighted cases of patients who had been inappropriately prescribed weight-loss injections, including individuals with eating disorders or those with body mass indexes (BMI) outside the licensed range. Such cases increase the risk of severe adverse effects.

Kaye added:
“Medicines are not like ordinary goods for sale; they must be handled with great care because they have the power to harm as well as to heal. We urge the GPhC to make a full consultation compulsory for high-risk medicines and ensure supply is prioritised for those with the greatest clinical need, including those with type 2 diabetes.”

Warning against unregulated sellers

The NPA and the Medicines and Healthcare products Regulatory Agency (MHRA) have also warned against purchasing weight-loss injections from unregulated sources, such as beauty salons or social media platforms. Counterfeit medications from these suppliers pose significant health risks.

The NPA advised patients to consult a pharmacist if they are unsure about weight-loss treatments, ensuring they receive safe and effective care as part of a programme to achieve sustainable lifestyle changes.