HYWEL Dda and Betsi Cadwaladr health boards have both failed again to meet their duty to break even over a three-year period, a new Audit Wales report has found.

After an unprecedented funding rise of £1.8 billion in 2020-21 (14.3 per cent real terms increase), health services in Wales received an uplift of 0.2 billion (two per cent real terms increase) in 2021-22.

Despite the uplift in funding, Hywel Dda, Betsi Cadwaladr and Swansea Bay health boards “all failed to meet their financial duty to break-even over a three-year period”, the report found.

“It has been another high-demand year for NHS Wales,” the Ausit Wales report outlines.

“The continuing impact of Covid-19 and significant increases in patients waiting for treatment have kept the NHS under constant pressure.

“Despite the significant funding there remains an overspend across NHS Wales.

“However, against a backdrop of significant pressure, the total in-year deficit was fairly static at £47.4 million (£47.9 million in 2020-21) and the three-year cumulative over-spend across the NHS reduced from £233 million to £184 million.”

Monthly returns to the Welsh Government show that health boards spent an additional net £0.88 billion in 2021-22 due to Covid-19, a 25 per cent reduction on the £1.1 billion reported for 2020-21.

Of this £0.88 billion, specific spend areas included £0.27 billion on vaccination, tracing and testing, £0.06 billion on personal protective equipment and £0.05 billion on field hospital/surge capacity.

Staff pay due to Covid-19 related activity was £0.4 billion, of which £0.03 billion was on agency staff.

This is only a small proportion of agency staff spend in 2021-22, which saw a 23 per cent increase from the previous year to £0.27 billion across NHS Wales.

Auditor General, Adrian Crompton said: “In the context of the ongoing pandemic and needing to respond to unprecedented service pressures, high levels of funding continued to be made available to the NHS in Wales in 2021-22.

“NHS bodies have faced the challenge of using that money to both respond to immediate service pressures and to also start to recover and reshape services to tackle backlogs and new patterns of demand.

“The focus on recovery and remodelling must continue into the current year and beyond but our data points to challenges with the workforce as evidenced by a growing expenditure on agency staffing, and a need to develop a more strategic approach to service transformation.

“As the peak of additional Covid funding subsides, NHS bodies will need to use the reinstated medium term planning process to set out a financially sustainable path to service recovery and modernisation.”