Health
NHS health boards in Wales fail to balance books amid rising pressures
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
Average of 18 deaths a week in Wales linked to A&E delays, figures reveal
NEARLY 1,000 deaths in Wales have been linked to long waits in accident and emergency departments, according to new data.
Figures published by the Royal College of Emergency Medicine (RCEM) estimate that 965 deaths in 2025 were associated with patients waiting 12 hours or more for care. That equates to around 18 deaths a week and marks an increase of 29 compared to 2024.
The RCEM has described the situation as a “tragedy” that should send shockwaves through the political system.
Dr Rob Perry, Vice President of RCEM in Wales, said his thoughts were with the families affected.
He said: “My heart goes out to the loved ones of anyone who died following long waits in emergency departments.
“These are often some of the most vulnerable patients — those who are seriously ill or injured and in need of urgent admission. They should be receiving timely care, but too often they are left waiting the longest.”
Dr Perry said the figures point to a wider failure across the healthcare system, highlighting a lack of hospital beds and what is known as “exit block” — where patients cannot be discharged due to delays elsewhere in the system.
He said improving patient flow through hospitals, rather than diverting people away from emergency departments, is key to tackling long waits.
With Senedd elections approaching, the RCEM is urging political parties to prioritise increasing hospital capacity and addressing overcrowding in emergency departments.
A Welsh Government spokesperson said too many people are still waiting too long for emergency care.
They said: “Long stays in emergency departments are distressing for patients and their families and can lead to poorer outcomes, particularly for older people and those with complex needs.
“We have made clear that health boards must improve patient flow, eliminate 12-hour waits and end care being delivered in temporary spaces.
“We are working with the NHS, local authorities and partners to reduce pressures by expanding community-based care and increasing social care capacity.
“We remain committed to improving outcomes for people who need emergency treatment.”
Community
Calls to block Withyhedge landfill expansion amid ‘worst in Wales’ claims
Campaigner and Senedd Member urge residents to respond as consultation deadline approaches
FRESH calls have been made to block the proposed expansion of Withyhedge Landfill, with residents warning that allowing further waste operations would be “outrageous” given the site’s recent track record.
Natural Resources Wales (NRW) is currently consulting on a permit variation application submitted by Resources Management UK Ltd (RML), which operates the Pembrokeshire site.
The consultation, which could allow the site to accept additional waste including up to 50,000 tonnes of “waste soils” per year, will remain open until Thursday (Mar 26).
The Herald has previously reported on ongoing issues at Withyhedge, including complaints of strong odours, gas emissions and concerns about potential health impacts in nearby communities.
In a formal objection submitted to NRW, long-time campaigner Colin Barnett said the regulator should not consider expanding the site while problems persist.
He said: “The public have had enough of ineffective regulation of Withyhedge Landfill by NRW’s hands-off minimal inspection process.
“We don’t want to breathe toxic gases from this landfill. We don’t want to be woken up in the night by poisonous gases trapped in our house and we don’t want to step out into our gardens to be chased inside from the insidious stink still being emitted from the pit of corruption.”
The objection raises concerns about the operator’s compliance record, claiming the site has been among the worst-performing permitted installations in Wales in recent years, with further issues identified following its reopening in 2025.
It also points to reported hydrogen sulphide emissions, which residents say have at times exceeded recognised odour guidelines and caused distress to those living nearby.
Barnett added: “RML, the waste company, will say they spent £10 million on resolving this problem. We would advise them to ask for their money back as we still get horrendous spikes of gas drifting into our communities.”
The proposed variation would also include revised restoration levels and changes to monitoring of groundwater, surface water and leachate.
However, objectors argue that the term “waste soils” is too vague and could include contaminated materials. Particular concern has also been raised about the site’s existing licence to accept asbestos and the potential risks of handling multiple hazardous waste streams.
Barnett said: “Of specific public concern is their request to tip asbestos on this site. Beggars belief.”
The objection also questions whether the permit process is being advanced ahead of any decision by Pembrokeshire County Council on increasing the site’s capacity.
Concerns have further been raised about what has been described as a “daisy chain” of companies linked to the site’s ownership, which objectors claim allows waste to be transported with limited oversight.
Barnett said: “The documents identify our concern with the ‘daisy chain’ of companies owned by David Neal that allow him to transport waste into our county with minimal inspection.”
Preseli Pembrokeshire MS Paul Davies has also urged residents to take part in the consultation, warning that local voices must be heard before any decision is made.
Mr Davies said: “This consultation is an important opportunity for residents to make their views known about the future of the Withyhedge landfill site.
“There have been ongoing concerns about the site’s environmental performance and its impact on local communities, and it’s vital that Natural Resources Wales hears directly from the people who live in the area.
“I have made clear to the Welsh Government that I believe the site should be looking towards closure rather than expansion, and that Pembrokeshire must not become a dumping ground for waste.
“I would strongly encourage residents to take part in the consultation and submit their views before the deadline.”
NRW’s consultation process is ongoing, and no final decision has yet been made.
The proposed changes are likely to intensify an already heated debate around Withyhedge, which has become one of the most contentious environmental issues in Pembrokeshire in recent years.
Health
Calls for urgent action as ‘corridor care’ concerns grow in Welsh hospitals
CONCERNS over patients being treated in hospital corridors have intensified after a new report highlighted the scale of pressures facing emergency departments across Wales.
The Royal College of Emergency Medicine has published findings describing the increasing use of so-called “corridor care”, where patients receive treatment in non-clinical areas due to overcrowding.
Responding to the report, Rhian Bowen-Davies warned that the situation risks becoming normalised unless urgent action is taken.
She said: “The findings offer further important insight into the scale and impact of care delivery in non-clinical environments and demonstrate why far more needs to be done.
“Words like ‘frightening’ and ‘warzone’ should never be used to describe aspects of our health service, yet this kind of language is increasingly common in reports from patients and staff, as well as in conversations I’ve had with older people and their loved ones across Wales.”
The Commissioner said there is growing evidence that corridor care is now an “everyday reality” within the NHS, driven by sustained pressures on services.
She added that the practice puts both the safety and dignity of patients at risk, particularly older people, who are more vulnerable when treated outside appropriate clinical settings.
Call for coordinated response
The Commissioner is now urging health boards and the next Welsh Government to take coordinated action to ensure patients are treated in suitable environments at all times.
She said improving conditions would not only help deliver safe and dignified care, but also rebuild public confidence in the health service.
“Restoring trust is crucial,” she added. “Many older people feel that confidence in the system has been lost.”
The report adds to mounting pressure on NHS services in Wales, where emergency departments have faced ongoing challenges with demand, staffing and patient flow.
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