KeepHealthCare.ORG – Lingering winter pressures squeeze health board coffers in Gwent
WINTER pressures on the NHS in Gwent, and the rising costs of mental health car packages, helped contribute to the area’s health board recording a deficit of almost £1.1 million for the first month of the 2018/19 financial year.
Aneurin Bevan University Health Board – like others in Wales and their counterpart organisations across the UK – endured an extremely busy winter.
It has been forced to keep open for much longer than estimated the extra beds that were a key part of its winter plan, as demand – fuelled by higher proportions of very sick patients, and the worst flu season since 2011 – remained exceptionally high.
This demand spilled into April and May, meaning that more staff were needed for longer, to care for the patients in these beds. This in turn has meant the continued use of agency nurses to support nursing teams.
Agency medical staff have also been required to sustain services like orthopaedics and ophthalmology.
More than 1,000 operations were cancelled during the winter, 812 of which were in March. This meant the health board missed its target for cutting waits of more than 36 weeks for treatment, and the need to play catch-up with this will impact on costs during the first months of 2018/19.
In April, 68 more orthopaedic patients than planned were treated.
Director of finance Glyn Jones told health board members these issues are tied up with ambitions within the three-year integrated medium term plan, to change services, the reduce the pressure on beds, and to reduce workforce costs.
“The deficit (of £1.09m) reflects where we are in terms of some of those pressures,” he said.
“There are opportunities to improve patient care and to be more efficient in the way we do it.”
Mr Jones also raised the issue of mental health continuing care packages as a factor in cost pressures.
He described the growth in such care packages, which can prove to be very expensive, as “significant”.
Additional packages of care that were required resulted in an extra £500,000 (above the set budget) being spent by the health board during April.
“We are potentially sending more and more patients out-of-county to deliver care packages,” he said, adding that it would be better for patients and for the health board if these could be provided in this area.
The health board drew up plans a number of years ago for its own facility to provide such complex mental health care, but this is now a project that is being looked at on a south Wales regional basis.
The health board needs to make a minimum of £20m in savings during 2018/19, as part of a wider plan to break even.
The current assessment is that £16m will be saved, and work is ongoing to identify the rest.