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Escalation level of Welsh Health Boards raised amid extreme financial challenges

13 Sep 2023 5 minute read
Health Minister Eluned Morgan

The Welsh Government has announced that all health boards will now be in some form of escalation status amid concerns about extreme financial challenges.

Last week, a report by Audit Wales found that six out of the seven health boards in Wales had failed to meet their statutory duty to break even over a three-year period.

The Welsh Government have said the financial pressures are a result health boards being faced with years of UK Government austerity measures and record levels of inflation.

There are four levels of intervention available, which trigger increased support for NHS organisations from routine arrangements (the lowest intervention level); enhanced monitoring; targeted intervention to special measures (the highest rate of intervention).

Due to the incredibly tough financial climate, health boards have been unable to submit financially balanced Integrated Medium-Term Plans.

Those health boards, which were not already in a form of intervention for planning and finance, will be escalated to enhanced monitoring.


Health Minister Eluned Morgan said: “It is disappointing that all health boards have been escalated to enhanced monitoring for planning and finance.

“We do not make these decisions lightly and it reflects the very difficult financial position we are in, as a result of inflation and austerity, and the challenges affecting health boards.

“We are seeing operational pressures, long waiting lists, and an extremely challenging financial position in the NHS – but this is not unique to Wales.

“We will support health boards to improve their financial planning positions, but some difficult decisions will need to be made as we work through this very tough financial challenge.

“In the coming weeks and months, together with the NHS, we will be working with the public to outline where savings need to be made to reduce these significant budget deficits.”

The Welsh Government say that significant improvements have been made at Cwm Taf Morgannwg University Health Board (CTMUHB), which have enabled the Minister to reduce the intervention level from targeted intervention to enhanced monitoring for maternity and neonatal services.

She said the change demonstrates the huge efforts made by staff at the units to turn around a very challenged department.

Hard work

The governance, leadership and culture, trust and confidence functions at the health board have also been de-escalated to enhanced monitoring following significant progress in addressing the concerns and recommendations raised in the 2019 Audit Wales and Healthcare Inspectorate Wales review.

The Health Minister added: “While there are still some areas where further improvements are required, it is clear progress continues to be made across Cwm Taf Morgannwg University Health Board.

“I am encouraged by these improvements and would like to thank all the staff at the health board for all their hard work in supporting and transforming maternity and neonatal services and governance, leadership and culture, trust and confidence functions.”

New escalation levels of the other NHS Health Boards, trusts and Special Health Authorities in Wales have also been set out today.

“Little faith”

Commenting on the news that the Labour Health Minister has escalated every health board in Wales to some level of enhanced monitoring, Welsh Conservative Shadow Health Minister, Russell George MS said: “This is a sad indictment of the state of our Labour-run Welsh NHS, after a quarter of a century of successive Labour Health Ministers, every health board in Wales is now at some level of government intervention due to poor performance.

“While it is positive that the Labour Health Minister is taking some action by acknowledging the dire state of our Welsh NHS, I have little faith given the lack of improvements we are seeing in health boards already being monitored that much will change in the coming months.

“Welsh Conservatives brought forward innovative solutions from surgical hubs to diagnostic centres and encouraged Labour to adopt Rishi Sunak’s NHS workforce plan, but instead we continue to see nearly 30,000 waiting for over two years for treatment in our Welsh NHS.

“Don’t forget that Wales has received a record funding settlement from the UK Conservative Government and for every £1 spent on health in England, Wales receives £1.20, yet Labour only spend £1.05 on the health service. Welsh Conservatives would ensure the full £1.20 is spent on our Welsh NHS.”


Calling the situation ‘serious”, Plaid Cymru’s Health and Care spokesperson Mabon ap Gwynfor MS said the Minister has “lost grip” on the “entire situation” and said it should not have taken until now for the government to take action.

Mr Gwynfor said: “All health boards in Wales are now in some form of escalated measures. This is serious.

“For the Government to publish this as a Written Statement with no opportunity for immediate Senedd scrutiny is a cynical move by a Minister that seems to have lost grip on the entire situation. It should not have taken until now for the Minister to realise the gravity of the situation health boards were in and to take action.

“The Health Minister must urgently address the implications of escalating intervention arrangements and provide both a clear picture of the financial wellbeing of Health Boards and a meaningful plan that gives confidence to patients, particularly with undoubted winter pressures approaching.”

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