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The Auditor General for Wales' opinion is that the financial statements give a TRUE and FAIR view of NHS Wales' finances, but four Local Health Boards failed to meet their financial duty to break-even over a three-year period.
The NHS (Wales) Summarised Accounts sets out the combined financial results of all 11 Welsh NHS bodies as at 31 March 2020, whose accounts were published in early July
Total Funding
£8.4 billion
Funding covers general running costs and asset purchases, and has increased by £0.6 billion compared to last year
Total Spending
£8.7 billion
| Primary Healthcare Services | £1.5 billion |
| Payments to GPs | £559 million |
| Payments to pharmacists | £133 million |
| Payments to dentists | £189 million |
| Payments to ophthalmologists | £43 million |
| Costs of drugs dispensed | £536 million |
| Other | £45 million |
| Healthcare from other providers | £0.9 billion | |
| Non Welsh NHS bodies | £289 million | |
| Local Authorities | £102 million | |
| Voluntary organisations | £54 million | |
| NHS Funded Nursing Care | £44 million | |
| Continuing Care | £371 million | |
| Private providers | £61 million |
| Hospital, Community & SHA | £5.9 billion |
| Employee Costs | £4,067 million |
| Supplies & Services | £842 million |
| Premises | £223 million |
| Other costs | £740 million |
What they own
£5.2 billion
| Total Assets | £5,240 million |
| Hospitals, transport, equipment and other assets | £3,644 million |
| Amounts due from the Welsh Government | £1,273 million |
| Cash Balances | £82 million |
| Medical and other supplies, including drugs | £85 million |
| Other amounts due to the NHS | £156 million |
What they owe
£2.2 billion
| Total Liabilities | £2,240 million |
| Amounts put aside for ongoing claims for medical negligence | £1,125 million |
| Other amounts owed by the NHS | £1,115 million |
Amounts paid out during the year on medical negligence claims was £106 million
Staff Costs
£4.2 billion
Staff numbers
83,800
Financial duties NHS Accounts Tool
... with accumulated deficits of £354 million over the last three years
The finances of NHS Wales were brought together in one set of accounts for the first time in 2019-20.
Three health boards in Wales overspent for the fourth year running. Some positive progress but the NHS Wales 2019-20 deficit was £89 million (2018-19 £96 million).
In July 2020, the Health Minister announced that when each of the four health boards achieves their three-year break even duty, their historic deficits will no longer be repayable.
Link to statement
Betsi Cadwaladr has remained in special measures since June 2015, with outstanding concerns relating to governance, finances and specific performance areas. Cwm Taf Morgannwg remained in special measures for maternity services.
Link to Betsi
Link to Cwm Taf
Additional funding allocated to NHS Wales for Covid-19 related expenditure up to 31st March 2020 was £15.491 million, and the scale of expenditure in 2020-21 is unprecedented.
Link to COVID 19 statement
A Ministerial Direction in December 2019 instructed the Welsh Government to fund certain pension tax liabilities for NHS clinicians. No additional costs resulted in 2019-20, but the Auditor General has drawn attention to a contingent liability for future costs reported in the accounts.
Link to Ministerial Direction
Healthcare services that you can find in your community, outside of hospital
Healthcare services that are provided by other organisations, not NHS Wales
This relates to expenditure incurred by Health Education and Improvement Wales, who have a leading role in the education, training, development and shaping of the healthcare workforce in Wales
The Welsh Government will reimburse NHS Wales for any medical negligence claims that are more than £25,000
the highest level of escalation that happens where there are concerns that the NHS body needs external support to respond to the serious concerns identified
this is a formal instruction from Welsh Ministers telling the Permanent Secretary to proceed with a spending proposal
this is a cost that may occur depending on what happens in the future, but the amount cannot be determined at this time
staff costs include salary and wages of £3.3 billion, pension costs of £0.6 billion and social security costs of £0.3 billion
Health Boards and NHS Trusts are required to breakeven over a three-year rolling period. The Special Health Authority is required to breakeven each year
Cardiff and Vale achieved breakeven for the year, but a cumulative three-year deficit means it failed its target