Skip to content

Written Statement - Medium Term Planning Update

Vaughan Gething, Cabinet Secretary for Health, Well-being and Sport

This is the fourth year of the planning arrangements following the introduction of the NHS Finance (Wales) Act 2014. NHS organisations received clear direction in the NHS Wales Planning Framework.   Health boards and NHS trusts are required to set out how resources will be used over a three-year period to:

  • Address areas of population health need and improve health outcomes;
  • Improve the quality of care;
  • Ensure best value from resources.
These are the first plans to be submitted following the implementation of the Well-being of Future Generations Act, and there has been liaison between the Commissioner’s office, the NHS and my officials to work towards ensuring that the five ways of working are driving the plans which will deliver health care to our population over the coming years.

A plan will only be approved following robust, board-level scrutiny and approval and when I, as Cabinet Secretary, am satisfied that it meets the requirements set out in the framework.  

I have decided to make an earlier decision on approval for six organisations that have submitted balanced and achievable plans. These organisations have demonstrated a growing maturity in their planning arrangements and I am able to recognise this with early approval.   This will allow these organisations continuity, an ability to act quickly and gives them longer to implement their plans.

Following a robust scrutiny process of the 2017-20 integrated medium-term plans, I have approved the following six organisations –
  • Aneurin Bevan University Health Board
  • Cwm Taf University Health Board
  • Powys teaching Health Board
  • Public Health Wales NHS Trust
  • Velindre NHS Trust, and
  • Welsh Ambulance Services NHS Trust.
I have set challenging accountability terms to ensure that we continue to drive improvement at pace through the health service, and avoid complacency in any organisations.  The performance of these organisations will continue to be reviewed regularly through the year.

The approval of a plan does not abdicate health board or NHS trust board accountability for the delivery of services, and nor does it prejudice the outcome of any due process required to implement the plan. Any service reconfiguration needed must be carried out in line with legislation and our existing guidance, for example, and any application for capital investment will be subject to the normal business case approval processes.

This year, four organisations did not submit Board approved three year plans.  These organisations are all in heightened escalation and are working with my officials to develop solutions to their ongoing challenges.  
The following organisations have not submitted approvable three year plans:

Betsi Cadwaladr University Health Board 

Assembly Members will be aware that Betsi Cadwaladr University Health Board continues to face a number of service and performance challenges, which require ongoing support. The health board’s response to these challenges will be set out in their one year plan.  

Hywel Dda University Health Board

Hywel Dda University Health Board faces ongoing strategic, service and financial challenges.  The health board will produce a one year plan which will allow the health board to focus on priority areas over the next year.   Officials are working closely with the health board to provide support as they develop and implement this plan, and work closely with neighbouring health boards to develop regional solutions to some long standing challenges. 

Abertawe Bro Morgannwg University Health Board

ABMU is developing a one year plan, and officials will continue to work closely with the health board as they develop longer term solutions.   The health board continues to experience challenges in relation to performance and financial control. 

Cardiff and Vale University Health Board

The health board faces ongoing financial and performance challenges which need to be resolved before the health board can achieve a sustainable position. 

Cardiff and Vale is developing a one year plan, and officials will continue to work closely with the health board as they develop longer term solutions.  


The three  year IMTPs are critical statements of the strategic and delivery intentions of NHS organisations. The approval process for such important plans must be rigorous. I expect Boards to ensure their organisations continually meet their plan approval conditions and deliver the commitments set out in their IMTPs.

Where Boards have been unable to deliver approvable three  year plans, my officials will consider appropriate arrangements to support them to submit IMTPs in 2018.