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On the 17 of October 2023, the Minister for Finance and Local Government provided an oral statement to the Senedd on the Welsh Government’s 2023/24 financial position. That statement detailed the outcome of the work over the summer to address the impact of the Welsh Government budget being worth around £900m less than it was when it was set in 2021\.


The NHS in Wales, like other healthcare systems, is facing the most challenging financial pressure in recent history. This is due to the impact of continued increasing demand on services, persistently high inflation on costs including energy, medicines, and pay related pressures, in addition to the impact of the pandemic and ongoing COVID\-related costs. In recognition of these challenges, an additional £425m has been allocated to support the NHS this financial year.


I have been working with Deputy Ministers and officials to review central budgets and repurpose funding towards NHS organisations where possible. Whilst this additional funding support is welcomed and essential, Health Boards will still need to make difficult decisions to balance their budgets both this financial year and next.


As a result of these actions, I can confirm that funding will be provided to organisations in support of the pay award commitments that have been agreed with and committed to our union partners. Local Health Boards have also been notified of the additional allocations being made in recognition of the challenges that are being faced, in addition to confirmation that each Local Health Board has been required to reduce planned deficits by 10%.


Plans submitted by Local Health Boards at the outset of this financial year detailed a combined deficit position of £648m. A 10% reduction to this planned deficit therefore equates to £64\.8m.


In addition to providing funding to support pay awards, additional allocations, which total £460\.2m, will be issued to Local Health Boards proportionately according to the established Local Health Board resource allocation formula. £336m of this funding is recurrent in nature and is conditional on each Local Health Board making progress towards the level of deficit which we have set for them to work towards (‘target control totals’) and which we will fund from the wider Health and Social Services budget. This constitutes £150m of funding to support organisational underlying deficits and the recurrent impact on the cost base as a result of the COVID pandemic, and £186m to support inflationary pressures including in relation to prescribing, medicines, and packages of care.


In addition, following the review of central budgets, a further £124\.2m will be provided to Local Health Boards on a non\-recurrent basis. Of this £75m is to further support inflationary pressures, and £49\.2m to support the additional costs of energy above historical baseline levels.


Following these allocations and deficit reduction expectations, revised target control totals have been set for Local Health Boards which across the seven Boards combine to total a deficit of £123m. These are target deficit positions for Local Health Boards to work towards achieving and are offset by funding within central budgets.


All Strategic Health Authorities \& NHS Trusts are forecasting to achieve financial balance and where there are opportunities to deliver financial improvement beyond those positions, I have asked my officials to ensure those opportunities are realised to support the delivery of this overall position.


I have also asked my officials, with support from the NHS Executive, to monitor progress against the target control totals set out, alongside implementation of actions with each organisation as part of the escalation framework. This includes working with organisations to support the delivery of savings that health boards have identified within plans and implementing processes to strengthen actions on a consistent national basis to support local savings delivery.


Delivery of the position set out will be challenging, but I expect progress to be made by Local Health Boards in delivering the target control totals set by organisation. We should be clear that these are not cuts to Local Health Board budgets, but Health Boards will need to take actions to reduce expenditure and manage to the target deficits we have set out. This will be an on\-going process and my officials will continue to work with all NHS Wales organisations in progressing delivery of the target forecast positions set out for the remainder of this financial year.


##### **Annex**


##### **Allocations \& Control Totals by Local Health Board**


 




|  |  | |  | | |  | |  |  | Conditionally Recurrent | | Non\-Recurrent | |  | |  | |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Local Health Board | | LHB Resource Allocation Formula Share | | Planned Deficit | 10% Reduction | | Adjusted Deficit | | | Underlying Deficit Contribution / COVID legacy | Inflationary Uplift | Inflationary Uplift | Energy | | Total allocations | | Control Total | |
| Aneurin Bevan | | 19\.2% | | 112\.9 | \-11\.29 | | 101\.61 | | | 28\.8 | 35\.7 | 14\.4 | 9\.50 | | 88\.3 | | 13 | |
| Betsi Cadwaladr | | 22\.2% | | 134\.1 | \-13\.41 | | 120\.69 | | | 33\.3 | 41\.3 | 16\.7 | 9\.80 | | 101\.1 | | 20 | |
| Cardiff and Vale | | 13\.5% | | 88\.4 | \-8\.84 | | 79\.56 | | | 20\.3 | 25\.1 | 10\.1 | 7\.60 | | 63\.1 | | 16 | |
| Cwm Taf Morgannwg | | 15\.2% | | 79\.6 | \-7\.96 | | 71\.64 | | | 22\.8 | 28\.3 | 11\.4 | 9\.40 | | 71\.9 | | 0 | |
| Hywel Dda | | 12\.8% | | 112\.9 | \-11\.29 | | 101\.61 | | | 19\.2 | 23\.8 | 9\.6 | 4\.20 | | 56\.8 | | 45 | |
| Powys | | 4\.2% | | 33\.5 | \-3\.35 | | 30\.15 | | | 6\.3 | 7\.9 | 3\.2 | 0\.90 | | 18\.3 | | 12 | |
| Swansea Bay | | 12\.9% | | 86\.6 | \-8\.66 | | 77\.94 | | | 19\.3 | 24\.0 | 9\.7 | 7\.80 | | 60\.7 | | 17 | |
|  | |  | | 648\.0 | \-64\.8 | | 583\.2 | | | 150\.0 | 186\.0 | 75\.0 | 49\.2 | | 460\.2 | | 123 | |


 


All figures £M


 


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Translation:


 
Ar 17 Hydref 2023, gwnaeth y Gweinidog Cyllid a Llywodraeth Leol ddatganiad llafar yn y Senedd ynghylch sefyllfa ariannol 2023/24 Llywodraeth Cymru. Yn y datganiad hwnnw, eglurodd y Gweinidog ganlyniad y gwaith a wnaed dros yr haf i fynd i'r afael ag effaith y ffaith bod cyllideb Llywodraeth Cymru yn werth tua £900 miliwn yn llai nag ydoedd pan gafodd ei gosod yn 2021\.


Mae'r GIG yng Nghymru, fel systemau gofal iechyd eraill, yn wynebu'r pwysau ariannol mwyaf heriol ers sawl blwyddyn. Mae'r galw ar wasanaethau yn parhau i gynyddu, ac mae chwyddiant yn uchel o hyd gan effeithio ar gostau pethau fel ynni a meddyginiaethau ac arwain at bwysau ar gyflogau. Yn ogystal, mae'r pandemig a chostau parhaus sy'n gysylltiedig â COVID yn dal i gael effaith. Gan gydnabod yr heriau hyn, mae £425 miliwn ychwanegol wedi'i ddyrannu i gefnogi'r GIG y flwyddyn ariannol hon.


Rwyf wedi bod yn gweithio gyda Dirprwy Weinidogion a swyddogion i adolygu cyllidebau canolog ac ailgyfeirio cyllid tuag at sefydliadau'r GIG pan fo hynny'n bosibl. Er bod y cymorth ariannol ychwanegol hwn i'w groesawu ac yn hanfodol, bydd angen i Fyrddau Iechyd wneud penderfyniadau anodd o hyd i fantoli eu cyllidebau yn y flwyddyn ariannol hon a'r flwyddyn ariannol nesaf.


O ganlyniad i'r camau hyn, gallaf gadarnhau y bydd cyllid yn cael ei ddarparu i sefydliadau i gefnogi ymrwymiadau'r dyfarniadau cyflog y cytunwyd arnynt â'n partneriaid o'r undebau ac yr ymrwymwyd iddynt. Mae Byrddau Iechyd Lleol hefyd wedi cael gwybod am y dyraniadau ychwanegol sy'n cael eu gwneud i gydnabod yr heriau a wynebir, yn ogystal â chadarnhad ei bod yn ofynnol i bob Bwrdd Iechyd Lleol sicrhau bod diffygion sydd wedi'u cynllunio yn cael eu lleihau 10%.


Roedd y cynlluniau a gyflwynwyd gan Fyrddau Iechyd Lleol ar ddechrau'r flwyddyn ariannol hon yn dangos bod y diffyg cyfunol yn £648 miliwn. Felly, mae sicrhau bod y diffyg wedi'i gynllunio hwn yn lleihau 10% yn gyfwerth â £64\.8 miliwn.


Yn ogystal â darparu cyllid i gefnogi dyfarniadau cyflog, bydd dyraniadau ychwanegol, gwerth cyfanswm o £460\.2 miliwn, yn cael eu gwneud i Fyrddau Iechyd Lleol mewn modd cymesur ar sail y fformiwla sefydledig ar gyfer dyrannu adnoddau i Fyrddau Iechyd Lleol. Mae £336 miliwn o'r cyllid hwn yn gyllid rheolaidd ac yn cael ei ddarparu ar yr amod bod pob Bwrdd Iechyd Lleol unigol yn gwneud cynnydd tuag at y lefel o ddiffyg yr ydym wedi'i gosod iddyn nhw weithio tuag ati ('cyfansymiau rheoli targed') ac y byddwn yn ei hariannu o'r gyllideb Iechyd a Gwasanaethau Cymdeithasol ehangach. Mae hyn yn cynnwys £150 miliwn o gyllid i gefnogi diffygion sylfaenol sefydliadol ac effaith reolaidd pandemig COVID ar y sylfaen costau, a £186 miliwn o gymorth yn sgil pwysau chwyddiant, gan gynnwys mewn perthynas â rhagnodi, meddyginiaethau, a phecynnau gofal.


Yn ogystal, yn dilyn yr adolygiad o gyllidebau canolog, bydd £124\.2 miliwn pellach yn cael ei ddarparu i Fyrddau Iechyd Lleol ar sail nad yw’n rheolaidd. O'r cyllid hwn, bydd £75 miliwn yn gymorth pellach yn sgil pwysau chwyddiant, a bydd £49\.2 miliwn yn cefnogi costau ychwanegol ynni sy'n uwch na lefelau sylfaenol hanesyddol.


Yn dilyn y dyraniadau hyn a'r disgwyliadau o ran lleihau diffygion, mae cyfansymiau rheoli targed diwygiedig wedi'u gosod ar gyfer Byrddau Iechyd Lleol. Ar draws y saith Bwrdd, mae hyn yn golygu mai £123 miliwn yw cyfanswm y diffyg. Diffygion targed yw'r rhain i Fyrddau Iechyd Lleol weithio tuag at eu cyflawni a chânt eu gwrthbwyso gan gyllid o fewn cyllidebau canolog.


Mae'r holl Awdurdodau Iechyd Strategol ac Ymddiriedolaethau'r GIG yn rhag\-weld y byddant yn sicrhau cydbwysedd ariannol a phan fo cyfleoedd i wella'r sefyllfa ariannol y tu hwnt i'r sefyllfaoedd hynny, rwyf wedi gofyn i'm swyddogion sicrhau bod y cyfleoedd hynny'n cael eu gwireddu i helpu i gyflawni'r amcan cyffredinol hwn.


Rwyf hefyd wedi gofyn i'm swyddogion, gyda chymorth Gweithrediaeth y GIG, fonitro cynnydd yn erbyn y cyfansymiau rheoli targed a nodwyd, ynghyd â rhoi camau gweithredu ar waith gyda phob sefydliad fel rhan o'r fframwaith uwchgyfeirio. Mae hyn yn cynnwys gweithio gyda sefydliadau i helpu i wireddu arbedion y mae byrddau iechyd wedi'u nodi o fewn cynlluniau a rhoi prosesau ar waith i gryfhau camau gweithredu ar sail genedlaethol gyson i helpu i wireddu arbedion lleol.


Bydd cyrraedd y targed a nodir yn heriol, ond rwy'n disgwyl i Fyrddau Iechyd Lleol wneud cynnydd tuag at gyflawni'r cyfansymiau rheoli targed a osodir fesul sefydliad. Dylem ei gwneud yn glir nad toriadau i gyllidebau Byrddau Iechyd Lleol yw'r rhain, ond yn hytrach bydd angen i Fyrddau Iechyd gymryd camau i leihau gwariant a rheoli'r diffygion targed yr ydym wedi'u nodi. Bydd hon yn broses barhaus a bydd fy swyddogion yn parhau i weithio gyda holl sefydliadau GIG Cymru i fynd ati i gyflawni'r targedau sydd wedi'u nodi ar gyfer gweddill y flwyddyn ariannol hon.


**Atodiad**


**Dyraniadau a Chyfansymiau Rheoli yn ôl Bwrdd Iechyd Lleol**


 




|  |  |  |  |  | Rheolaidd dan Amod | | Ddim yn Rheolaidd | |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Bwrdd Iechyd | Cyfran Fformiwla Gofal Iechyd a Gwasanaethau Ysbyty 23\-24 | Diffyg wedi'i Gynllunio | Gostyngiad o 10% | Diffyg wedi'i Addasu | Cyfraniad at Ddiffyg Sylfaenol / gwaddol COVID | Taliad yn sgil Chwyddiant | Taliad yn sgil Chwyddiant | Ynni | Cyfanswm y dyraniadau | Cyfanswm Rheoli |
| Aneurin Bevan | 19\.2% | 112\.9 | \-11\.29 | 101\.61 | 28\.8 | 35\.7 | 14\.4 | 9\.50 | 88\.3 | 13 |
| Betsi Cadwaladr | 22\.2% | 134\.1 | \-13\.41 | 120\.69 | 33\.3 | 41\.3 | 16\.7 | 9\.80 | 101\.1 | 20 |
| Caerdydd a'r Fro | 13\.5% | 88\.4 | \-8\.84 | 79\.56 | 20\.3 | 25\.1 | 10\.1 | 7\.60 | 63\.1 | 16 |
| Cwm Taf Morgannwg | 15\.2% | 79\.6 | \-7\.96 | 71\.64 | 22\.8 | 28\.3 | 11\.4 | 9\.40 | 71\.9 | 0 |
| Hywel Dda | 12\.8% | 112\.9 | \-11\.29 | 101\.61 | 19\.2 | 23\.8 | 9\.6 | 4\.20 | 56\.8 | 45 |
| Powys | 4\.2% | 33\.5 | \-3\.35 | 30\.15 | 6\.3 | 7\.9 | 3\.2 | 0\.90 | 18\.3 | 12 |
| Bae Abertawe | 12\.9% | 86\.6 | \-8\.66 | 77\.94 | 19\.3 | 24\.0 | 9\.7 | 7\.80 | 60\.7 | 17 |
|  |  | 648\.0 | \-64\.8 | 583\.2 | 150\.0 | 186\.0 | 75\.0 | 49\.2 | 460\.2 | 123 |


Pob ffigur £M