Written Statement - Medium Term Planning Update

This is the fifth 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, which was issued in October 2017.  Health boards and NHS trusts are required to set out in their Integrated Medium Term Plans how resources will be used over a three-year period to:

• Address areas of population health need
• Improve health outcomes and quality of care; and
• Ensure best value from resources.

These are the first plans to be submitted following the publication of the National Strategy: Prosperity for All and the publication of the findings from the Parliamentary Review of Health and Social Care in Wales.  The implementation of Prosperity for All has had direct implications on the way in which organisations have constructed their plans, and this year we are beginning to see an increased focus on cross sector working, collaboration and a continued emphasis on well-being and sustainability, in line with the Well-being of Future Generations Act.  Going forward plans will of course be aligned to the Long Term Plan for health and social services, but organisations were able to take account of findings of Parliamentary Review in preparing their current submissions.

I have decided to approve six organisations that have submitted balanced and achievable three year plans.  They have demonstrated a growing maturity in their planning arrangements and I am pleased to be able to recognise this with approval. I look forward to seeing the progress of transformational service change that these organisations have set out in the plans over the next three years.

Following a robust assessment process, I have approved the integrated plans from 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 expect these organisations to continue to drive improvement at pace, working across health board and trust boundaries and with public and third sector partners to deliver services for patients in Wales.  

Performance of these organisations will continue to be reviewed regularly throughout the three year cycle.

The approval of a plan does not 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 and any application for capital investment will be subject to the normal business case approval processes.

Four organisations were unable to submit Board approved three year plans. They are all in heightened levels of escalation and are working with my officials to develop solutions to their ongoing challenges.  

Betsi Cadwaladr University Health Board

Assembly Members will be aware from my statement last week that Betsi Cadwaladr University Health Board continues to face a number of service, finance and performance challenges which require ongoing support.  The health board’s response to these challenges in 2018 will be set out in their detailed one year annual operating plan.  
 

In addition, my statement explained that Welsh Government will be providing more intensive support to deliver improvements that includes work towards developing an agreed IMTP. 

Hywel Dda University Health Board

Hywel Dda University Health Board continues to face ongoing strategic, performance and financial challenges.  The health board will produce a one year annual operating 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.  The Transforming Clinical Services consultation is still ongoing and once concluded will inform the future direction of services across the health board. 

Abertawe Bro Morgannwg University Health Board

ABMU is developing a one year annual operating plan to address performance and financial challenges.  I expect the changes at Board level and Executive appointments to drive the progress that is required both in the short and medium term.  Whilst the organisation’s planning and financial position is showing positive signs of improvement, officials will continue to work closely with the health board as they develop longer term, sustainable solutions.  My officials continue to work closely with the organisation to provide the necessary support and challenge as they work towards a sustainable solutions.

Cardiff and Vale University Health Board

The health board has made some progress and is improving some key performance areas, however it has ongoing  financial challenges which need to be resolved before the health board can achieve a sustainable position.   While there has been stabilisation, further focus is required to deliver a balanced financial position.

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

The three year IMTPs are critical statements of the strategic and delivery intentions of NHS organisations.  They must reflect the level of organisational maturity and control that is required in a planned whole system approach.  Therefore the approval process and ongoing monitoring for such important plans must be rigorous.  I expect Boards to ensure their organisations continually review their plans l and ensure they deliver the commitments within them.

Where Boards have been unable to provide approvable plans in this planning cycle, my officials will support them to work towards submission of an integrated three year plan for 2019.