Our report finds that financial management is getting better although some NHS bodies over-spent, service performance was mixed and major challenges remain on the horizon.
NHS Wales broke even in 2013-14, despite three health boards being over spent, according to a report released today by the Auditor General for Wales.
The annual report, NHS Wales: Overview of Financial and Service Performance 2013-14, focuses on three main areas; financial management, performance targets and future planning of the Welsh NHS.
The report found that break even was achieved by the Welsh Government’s Department of Health and Social Services receiving an additional £200 million of funding from other departments and reserves and NHS bodies having to make significant financial savings. It also found that three NHS bodies failed to break even resulting in their accounts being qualified.
The Auditor General for Wales, Huw Vaughan Thomas said “Despite significant effort, NHS bodies are finding savings increasingly difficult to manage and this was underlined by three NHS bodies having their accounts qualified earlier this year.
It is good to see performance in areas such as prevention is improving but some cancer and stroke care targets are not being met and waiting times have generally got worse.
Although it is positive that NHS Wales is introducing a three year framework, there are still a number of risks and challenges ahead that will test and challenge the NHS not exceed their allocated revenue and capital budgets.
What is clear is that the NHS cannot continue as it is, some tough decisions will need to be made to change the way services are provided and this will require the support of politicians”.
The report also found that service performance across NHS Wales in 2013-14 was “mixed” and many key targets, such as waiting times for planned and emergency services, were not regularly achieved. Looking forward, the report identifies that three-year integrated planning is a positive step forward but “NHS Wales will struggle to make progress without transformational change”.
The report identifies several positive points, highlighting the commitment to finding savings by NHS bodies, positive progress against some performance targets (specifically mortality data and integration of different parts of the NHS) as well as the potential for the emerging ideas about ‘prudent healthcare’ to lead to better services at lower cost.
The report makes a number of recommendations to improve financial and service performance that include:
- NHS bodies need to more consistently report their financial positions to the Department.
- Capital expenditure in areas such as buildings and equipment need to be better quantified and prioritised at an all-Wales level.
- The quality of the three-year integrated plans need to improve.
- NHS bodies need to better understand their workforce savings plans.
- More can be done to share good practice and lessons learnt.