Financial pressures on the NHS prompt change in PTHB escalation status

The national escalation status for PTHB has been increased from “enhanced monitoring” (level 3) to “targeted intervention” (level 4) for finance, strategy and planning.

As you may be aware, Welsh Government has a put in place national Joint Escalation and Intervention Arrangements. Through these arrangements they meet at least twice a year with Audit Wales and Healthcare Inspectorate Wales to discuss issues and concerns about each Health Board, Trust and Special Health Authority.

As part of the Joint Escalation and Intervention Arrangements. HBs, Trusts and SHAs in Wales are given an intervention and escalation status in five bands:

• Routine Arrangements (level 1)
• Area of concern (level 2)
• Enhanced Monitoring (level 3)
• Targeted Intervention (level 4)
• Special Measures (level 5)

The NHS across the country is facing a very challenging context in terms of finance and planning, and this is very much reflected in our position here in Powys:

• 2022/23 was the first time since 2015 that PTHB did not achieve a break even financial position, ending the year with a deficit of £7m.
• For 2024/25, the plan that we have submitted to Welsh Government will end the year ahead with a £23m deficit position.
• Our overall budget is around £400m per year. This means we spend just over £1m every day, but our deficit position means we spend £90,000 every day that we cannot afford.

Given this, we very much expected that Powys Teaching Health Board would be escalated from “enhanced monitoring” to “targeted intervention” for finance, strategy and planning. This will mean greater scrutiny and support from Welsh Government. It also means that as a Board we will continue to keep our focus firmly on quality, delivery and finance.

We remain in “routine arrangements” for all other aspects of Health Board delivery.

Delivering a balanced plan since 2015 to 2022 - along with your exceptional compassion, commitment and skills - clearly shows the great track record we have in PTHB, which gives us confidence that we have the right foundations to come through these challenges. As we have been sharing over recent months, work is also underway to develop our routemap to sustainability, we will continue to develop this working closely with our staff, partners and the public in ensuring we have a sustainable health service in Powys for the future.

Given rising costs and increasing demand, we all need to be part of an open and honest conversation with the public about what the future health and care service looks like to ensure the sustainability of the NHS in Wales.

Hayley Thomas, Chief Executive, 

More information about this announcement and the escalation status for all health boards in Wales is available from the Welsh Government website at Oral Statement: NHS Wales organisations – escalation update (5 November 2024) | GOV.WALES