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
The growing popularity of overseas medical care
With waiting lists ever increasing and appointments seemingly booked up forever, more and more people are seeking alternative methods to get the medical care they need. While going private is an option for some, for others, the costs are simply too high, treatments are not specialised enough, or waiting lists remain lengthy. This is why many people are starting to go abroad for their treatment needs. So, with that in mind, let’s explore why overseas medical care has grown in popularity.
Shorter wait times
In 2024, more than 500,000 Britons chose to get treated abroad to avoid lengthy wait times on the NHS, more than double compared to numbers reported in 2021. With waiting lists continuously on the rise, it’s becoming increasingly difficult for people to get the treatment they need when they need it. The result is more and more people heading overseas to receive the right medical care.
Lower costs
The expense of going private in the UK versus going private abroad is significant. For example a hip replacement in the UK costs around £12,000 to £18,000 privately, but will cost around £1,600 to £5,000 in India. These reduced expenses make medical care more accessible to those on lower incomes, increasing the appeal of overseas medical care.
Specialised treatments or experimental therapies
Some countries have dedicated more time and effort into certain health conditions than others. For example many people seek epilepsy treatment in Germany, thanks to the country’s reputation for advanced investment into the condition.
Some tests, treatments, and experimental therapies aren’t available in the UK, causing people to venture further afield to make progress with their health.
Easier access to information
Thanks to technology like the internet and social media, it’s now easier than ever to research practices, facilities, and treatment options in different countries. Those who are dubious about going abroad for medical treatment, can now get the reassurance they need to go ahead.
And it’s not just the treatment itself, but the travel and accommodation, too. It’s never been easier to compare prices for airplane tickets, hotels, and transfers, making the entire process straightforward.
What does the future of medical care look like?
It’s evident that for Brits, going overseas is becoming increasingly popular. As NHS wait times and private costs increase, the appeal of treatment overbroad will likely continue to rise.
Health
£2m hospital upgrade to ease A&E pressure at Carmarthen site
MAJOR refurbishment work has begun at Hywel Dda University Health Board’s Glangwili Hospital after more than £2 million in funding was secured from the Welsh Government.
The £2.096m investment will be used to overhaul the hospital’s Same Day Emergency Care (SDEC) unit, creating extra consultation rooms, a redesigned reception, and a more comfortable environment for both patients and staff.
Health chiefs say the expanded unit will help reduce pressure on the hospital’s busy Emergency Department by allowing more people to be treated quickly without needing an overnight stay.
The project forms part of wider efforts to improve urgent and emergency care across the health board’s sites, including the Minor Injury Unit at Prince Philip Hospital.
Keith Jones, Director of Operational Planning and Performance for the health board, said the funding would increase capacity and speed up patient flow.
He said: “This investment will help us reduce pressure on the Emergency Department and provide a smoother, swifter experience for patients. We’re grateful to Welsh Government for the support.”
Services temporarily relocated
While the work takes place, several services have moved elsewhere on the hospital site.
The SDEC unit, Discharge Lounge and Medical Day Unit have relocated to Y Lolfa, formerly Padarn Ward.
The Cancer Information and Support Service and Cancer Psychological Support Service have also moved, although contact details remain unchanged.
Some clinics, including podiatry, neuro-rehabilitation and occupational therapy, will stay at the Priory Day Hospital, but patients may need to use different access routes.
Patients are being notified through appointment letters, and extra signage will be in place around the hospital. Staff are urging visitors to check their letters carefully or contact departments directly if unsure where to attend.
Cabinet Secretary for Health and Social Care Jeremy Miles said the upgrade would help tackle overcrowding and delays.
He said: “This investment will reduce waits, ease handover pressures and improve the overall experience for patients and staff when they need urgent or emergency care.”
Work is expected to continue over the coming months.
Community
Work on new 26-home Pembrokeshire development gets underway
CONSTRUCTION work has started on a Haverfordwest scheme to provide sheltered housing apartments for the over-55s.
The Tŷ Haverfordia affordable housing and reablement development of 26 sheltered housing apartments for the over-55s alongside a dedicated 12-bed reablement centre to support residents returning home from hospital at the former Haverfordia House site, delivered by Wynne Construction, forms part of Pembrokeshire County Council’s “continued commitment to increasing high‑quality, accessible housing and deliver effective modern health and social care support across Pembrokeshire”.
Initial works began on January 26 and include securing the site, setting up a small compound and contractor parking area, installing controlled access for site personnel, and positioning temporary office and welfare units.
To maintain safe access to nearby facilities, including the GP surgery and Haverfordwest Leisure Centre, pedestrian routes through the area will remain open.
In addition, a minimum number of public parking spaces, including disabled bays, have been kept with Pay & Display machines relocated to reduce inconvenience.
In keeping the minimum number of parking spaces as well as needing to accommodate essential contractor welfare facilities, a small section of Rifleman Field has had to be used during the duration of the development of the site.
This space will be securely fenced off, and the footprint minimised. Any areas of Rifleman Field affected by the works will be fully reinstated on completion and restored to a condition that is equal to or better than at present.
To ensure residents and stakeholders are kept informed and have the opportunity to engage with the development, Pembrokeshire Housing Services will be hosting a Community Engagement Drop-in Event on Thursday, February 19, 5-7pm, at The Green Room, Haverfordwest Leisure Centre.
Pembrokeshire County Council Cabinet Member for Housing, Cllr Michelle Bateman, said: “I am pleased that we have finally reached the stage of commencing on site and look forward to seeing the development progressing.
“We have been able to progress with the development after receiving much-needed Welsh Government grant assistance for both the reablement and housing parts of the development.”
Last year, Pembrokeshire County Council’s Cabinet, members approved awarding a fixed contract of £13,560,454.21 to C Wynne & Son for the Haverfordia House works.
In 2019, Cabinet backed the acquisition of the freehold of Haverfordia House, with the overall intention to deliver a new housing and wellbeing facility following its demolition.
A report for members at last year’s June meeting said: “As well as providing long-term residents with a sense of place and community, it will provide short-term reablement users with the facilities and in-house support which they need to relearn the skills required to keep them safe and independent when they return home.”
It said there was a need for one-bed properties, and a review of sheltered over 55 accommodation was undertaken in 2018-19 which identified that existing sheltered housing stock is “no longer fit for purpose”.
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