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Over one in four care seekers in Wales unsure who will pay for care as costs soar

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A NEW report has uncovered significant uncertainty surrounding elderly care funding in Wales, with more than a quarter of care seekers unsure who will bear the costs. Data from carehome.co.uk, a leading reviews website, shows that 26% of Welsh care seekers who inquired between November 1, 2023, and October 31, 2024, did not know how their care would be funded—surpassing the UK national average of 21%.

Self-funding: A growing trend

Among those with a clear funding plan, 41% in Wales stated they would self-fund their care. This figure compares with 53% in England, 40% in Northern Ireland, and 37% in Scotland, highlighting regional differences in funding approaches.

Local authority funding and the rise of top-up fees

The research reveals that 13% of Welsh care seekers rely on local authority funding, aligning with the UK average. However, with local councils under financial strain and care home fees climbing, many families face additional “top-up” costs to bridge the gap between council contributions and actual fees.

In Wales, 13% of care seekers anticipate paying top-up fees, a growing challenge as families struggle to meet rising expenses.

NHS continuing healthcare: A complex system

Only 7% of care seekers in Wales expect to benefit from NHS continuing healthcare funding, slightly above the UK average of 5%. This funding, which is not means-tested, covers full care costs for adults with complex health needs. However, critics point to inconsistencies in assessments across regions.

James Urquhart-Burton, a partner at Ridley and Hall Solicitors, described the issue:
“Your chances of getting NHS continuing healthcare funding vary based on your location, which is a problem given that the criteria are standardized nationwide. The reliance on assessors’ judgments to determine need introduces subjectivity into the process.”

Rising costs and public confusion

Sue Learner, editor of carehome.co.uk, expressed concern over widespread confusion about care funding:
“Our data shows an acute lack of understanding among the public in Wales about how the social care system works and how to navigate it. It’s incredibly concerning that a significant proportion of care seekers still don’t know whether the council or they themselves will cover costs.”

Learner highlighted the financial strain on self-funding residents, with care home fees in Wales averaging £1,066 per week. Rising costs—driven by increases in National Insurance, the National Living Wage, energy bills, and food prices—add to the burden.

“Care homes are increasingly prioritizing self-funding residents due to financial pressures,” she added. “This trend may reduce the number of care homes accepting state-funded residents, leaving families to grapple with an already complex system.”

As care costs continue to rise, understanding funding options and planning ahead are becoming critical for families across Wales.

Pictured: Shani Lauren Escott at Pen Coed Care Home, Saundersfoot with resident May Spurr

Health

Fresh alarm over life expectancy in Wales as CMO warns of ‘prevention revolution’

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WALES is living sicker for longer, the Chief Medical Officer has warned, as new figures show a worrying drop in the number of years people can expect to live in good health – with women hit hardest.

The findings, published today in Dr Joanne Absolom’s first annual report since taking over from Sir Frank Atherton, have prompted immediate calls for the next Welsh Government to overhaul its approach to public health after the 2026 Senedd election.

Dr Absolom says Wales must now move decisively away from a system that largely treats illness towards one that prevents people becoming ill in the first place. Her report warns that healthy life expectancy is falling across the country and highlights widening inequalities between communities.

Responding to the findings, Darren Hughes, Director of the Welsh NHS Confederation, said the message could not be clearer.

“NHS leaders in Wales welcome the report’s call for a prevention-first approach,” he said. “We have to move from simply treating illness to actively promoting wellbeing, and that means a proper cross-government strategy that tackles inequality and gives people the support to take control of their own health.”

He added that every pound spent on proven public health programmes delivers an average return of £14 – evidence, he said, that prevention “makes moral and financial sense” at a time when NHS budgets are under extreme pressure.

“It is deeply concerning to see healthy life expectancy falling, particularly for women,” he said. “Investment in prevention is vital if we are to make our health and care services sustainable.”

While health boards, councils and community groups are already working on preventative programmes, the Welsh NHS Confederation says Wales needs far greater ambition – and the NHS must be given the tools and flexibility to scale up what works.

The Chief Medical Officer’s report also raises serious concerns about NHS workforce shortages and urges significant investment in digital technology to improve productivity and patient outcomes.

Mr Hughes said all political parties should “take heed” as they prepare their manifestos for next year’s Senedd election.

“Those seeking to form the next Welsh Government have a clear blueprint here. We cannot keep doing the same things and expect different results. Prevention, workforce and digital transformation have to be top priorities.”

The Welsh NHS Confederation — which represents all seven health boards, the three NHS trusts, HEIW and Digital Health and Care Wales — has already outlined its detailed priorities in its own election document, Building the health and wellbeing of the nation.

With the Senedd election just over a year away, today’s report adds fresh, authoritative evidence that Wales needs a radical shift in how it approaches health if it is to secure a healthier future for all.

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Health

Government orders clinical review amid sharp rise in mental health diagnoses

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4.4 million working-age people now claiming sickness or incapacity benefit, up by 1.2 million since 2019, many because of a mental health condition

A CLINICAL review into how mental health conditions are diagnosed across the UK is expected to begin this week, following concerns within government over rapidly rising sickness-benefit claims linked to conditions such as autism, ADHD and anxiety.

Health Secretary Wes Streeting has commissioned leading clinical experts to examine whether ordinary emotional distress is being “over-pathologised” and to assess why the number of people receiving sickness and incapacity benefits has grown to 4.4 million – an increase of 1.2 million since 2019.

According to reports in The Times, ministers are particularly alarmed by the surge in the number of 16- to 34-year-olds now out of work because of long-term mental health conditions.

Streeting said he recognised “from personal experience how devastating it can be for people who face poor mental health, have ADHD or autism and can’t get a diagnosis or the right support,” but added that he had also heard from clinicians who say diagnoses are “sharply rising”.

“We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us about our mental health system, autism and ADHD services,” he told the newspaper. “That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”

The review is expected to be chaired by Prof Peter Fonagy, a clinical psychologist at University College London specialising in child mental health, with Sir Simon Wessely, former president of the Royal College of Psychiatrists, acting as vice-chair.

Prof Fonagy said the panel would “examine the evidence with care – from research, from people with lived experience and from clinicians working at the frontline of mental health, autism and ADHD services – to understand, in a grounded way, what is driving rising demand.”

The move comes as the UK Government faces mounting pressure over the rising welfare bill. Ministers earlier this year pulled back from proposed changes to disability benefits, including those affecting people with mental health conditions, after opposition from Labour backbenchers.

Speaking on Monday, the Prime Minister said a fresh round of welfare reform was needed.

Keir Starmer said: “We’ve got to transform it; we also have to confront the reality that our welfare state is trapping people, not just in poverty, but out of work.”

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Health

NHS Trust CEO ‘forced out’ after raising concerns — Welsh Govt denies wrongdoing

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A CONSERVATIVE MS has pressed the Welsh Government for answers after the sudden departure of the Velindre University NHS Trust’s chief executive, amid media reports that he raised concerns about alleged governance failures within NHS Wales Shared Services.

During Health Questions in the Senedd today, James Evans MS asked Health Secretary Jeremy Miles to explain why former CEO David Donegan left his post after just a year. Reports circulating in recent weeks suggest Mr Donegan had raised issues relating to governance, and in some accounts, possible criminality. These claims have not been substantiated publicly.

Velindre’s own 2024/25 annual report notes that the Trust “escalated concerns to Audit Wales and Welsh Government about the current governance of Shared Services, which hadn’t been reviewed since 2012.” No details of the concerns have been published.

Welsh Government response

Jeremy Miles MS confirmed in the chamber that correspondence relating to the issues does exist, but said it would not be appropriate to release sensitive material while internal processes are ongoing. He did not comment on the circumstances of Mr Donegan’s departure, citing employment confidentiality rules which are standard across the NHS and public sector.

A Welsh Government spokesperson has previously said that they expect all NHS bodies to follow “proper governance and HR procedures,” and that they “do not comment on individual employment matters.”

Velindre NHS Trust position

Velindre has not publicly stated that Mr Donegan was removed because of whistleblowing activity. The Trust has described his departure simply as a “change in leadership” and says it continues to engage with Audit Wales and the Welsh Government on governance matters.

Opposition criticism

After the exchange, James Evans MS — the Welsh Conservative Shadow Cabinet Secretary for Health — criticised the Health Secretary’s “lack of transparency”.

He said:

“I am extremely disappointed with the Health Secretary’s refusal to provide clarity on the circumstances surrounding Mr Donegan’s departure, or to release the correspondence relating to governance concerns within Shared Services. The public must be able to trust that millions of pounds of NHS funds are being managed properly.”

Mr Evans said he will write to the First Minister and Cabinet Secretary formally requesting the publication of correspondence “in the interests of full accountability.”

Context: What is NHS Shared Services?

The NHS Wales Shared Services Partnership (NWSSP) manages national procurement, payroll, recruitment, estates services and other core functions for health boards and trusts. It sits within Velindre University NHS Trust but operates independently of its operational healthcare work. Governance arrangements for NWSSP were originally set a decade ago and are subject to periodic review by Audit Wales.

There is no evidence at present of wrongdoing by the Welsh Government or NWSSP, beyond the concerns referenced in Velindre’s annual report.

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