Vaughan Gething AM, Minister for Health and Social Services

First published:
11 April 2019
Last updated:

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The Countess of Chester NHS Foundation Trust (CoCH) has taken a unilateral decision not to accept any new elective referrals for Welsh patients from the 1 April. This decision does not impact maternity patients, those attending the Accident and Emergency Department and patients from North Wales who are already waiting for treatment at the CoCH.

The decision relates to referrals in to all specialties, including urgent suspected cancer and both urgent and routine planned (also known as elective) referrals. The level of monthly elective referrals from Wales to CoCH is around 700 patients. I have been very clear that the action taken is unacceptable and not in line with the statement of values and principles agreed between the NHS in Wales and NHS in England that we will act in the best interest of patients at all times. Residents in Flintshire have a long history and relationship with the hospital. Funding from treating patients from Wales has always been and continues to be essential to the viability of CoCH.

The unilateral CoCH action relates to significant change for 2019/20 on the structure of the tariff system and rates that determine the amounts payable to provider trusts in England for treatment of patients. This tariff system technically does not apply to cross-border healthcare but has previously been used as the basis for payment to provide consistency. The tariff rate changes agreed for 2019/20 by NHS England agencies include additional costs from staff pay deals that should not be chargeable to NHS Wales organisations. To agree the financial impact for Wales, my officials have agreed a process of direct engagement with the Department for Health and Social Care officials, along with representatives from NHS Wales and the NHS England. Discussions have been constructive and representatives from the NHS in England are considering the issues raised by Wales ahead of a further agreed meeting later in April.

In light of the decision taken by the CoCH I immediately asked officials to engage with the UK Government Department for Health and Social Care.  We have requested it takes action to de-escalate the position and I will be following this up directly with Ministers in the UK Government this week. My priorities are to urgently resolve this local issue and ensure we have robust and fair cross border payment arrangements agreed that has patient care at its forefront.

Officials have been actively engaging with Betsi Cadwaladr University Health Board (BCUHB) to ensure that discussion and communication is taking place with partners and information and support is being provided to patients. BCUHB are putting in place interim systems and processes to ensure that patients receive the care they need.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Assembly returns I would be happy to do so.