Health board faces ‘exceptionally challenging’ task to save £65m

Richard Youle, Local Democracy Reporter

A health board is aiming to save £65m this financial year and detailed plans are being drawn up to meet the target.

The savings at Swansea Bay University Health Board are needed to help tackle a projected deficit of £76.6m in 2026-27 caused by an expanding workforce, pressures in urgent, and planned care and a failure to achieve a chunk of savings the previous year among other things.

A health board report described the £65m savings target as “exceptionally challenging” and said many cost-cutting proposals were in the pipeline or an early stage of development.

It said the health board, which runs hospitals and other clinical services in Swansea and Neath Port Talbot, needed to gain more confidence it could deliver these savings.

Board members heard this work was progressing at a meeting. “We’ve got to get the message out to staff about the need to hold on tight for the time being because it will come right over a period,” said one of them.

The plan to hit the £65m target, according to a health board document submitted to the Welsh Government last month, includes savings in planned and emergency care (£18.1m), the medical workforce (£15.7m), the nursing workforce (£6.9m), and productivity and efficiency gains (£9.2m).

Board members were given an update as part of a discussion about an annual plan that’ll be resubmitted to the Welsh Government for approval after the first draft was deemed unacceptable.

The health board had submitted the first draft for scrutiny rather than approval as it knew it wouldn’t meet the criteria required, particularly in respect of the financial deficit and a lack of clarity about how improvements could be made quickly.

Board members heard that significant work had taken place to strengthen both the annual plan and financial control. The health board report said the aim was to finalise a “credible” plan by the end of this month. This will include converting millions of pounds of pipeline savings into clear, achievable schemes.

The report said: “The focus must now shift from identifying savings to demonstrating deliverability.”

A new delivery unit is to coordinate and oversee this work.

The revised annual plan will also provide more detail on how continued improvements can be made in urgent and emergency care, planned carem and cancer treatment times.

Some board members were worried about the organisation’s capacity to implement savings plans and their potential effect on staff morale. Independent board member Anne-Louise Ferguson said this might in turn affect staff sickness levels.

“We’ve got to get the message out to staff about the need to hold on tight for the time being because it will come right over a period,” she said. “It is a really hard ask – that’s a huge risk in my view, of people thinking: ‘I’ve tried everything, it’s more (savings), what do we do next?’”

Jon Scott, director of the delivery unit, said the health board was supporting people back into work from sickness absence. “I think overall on the grip and control side this is a really important thing that we need people to be engaged with,” he said.

“We need to talk about it because we need to resolve this and we need to resolve it against the plan we have got.”

The health board’s day-to-day net budget exceeded £1.4bn in 2024-25, according to published accounts, an increase of £138m on the previous year. Its workforce, including agency staff and specialist trainees, was just over 13,600, nearly 300 more than in 2023-24.

Board chairwoman Jan Williams said: “We have more nurses than we’ve ever had.”