Written statement - Medium term planning update

This is the third year of the planning arrangements following the introduction of the NHS Finance (Wales) Act 2014. The NHS Wales Planning Framework marked a new approach to planning in the Welsh health service, requiring health boards and NHS trusts to set out how resources will be used over a 3 year period to:

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

The Welsh Government has strengthened the planning arrangements over the last 12 months to reflect lessons learned from the first 2 years of this new planning regime. 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.

The approval of a plan does not abdicate health board or NHS trust board accountability for the delivery of services 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.

Following a robust scrutiny process of the 2016-19 integrated medium-term plans, I have approved the following 6 organisations – Aneurin Bevan and Cwm Taf University Health Boards, Powys teaching Health Board, Public Health Wales, Velindre, and Welsh Ambulance Services NHS Trusts.

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 be reviewed regularly through the year.

This is the first year that WAST’s plan has been approved, and reflects the improvements that have taken place within this trust, supported by EASC, over the last 2 years.

Betsi Cadwaladr University Health Board

Assembly Members will be aware that Betsi Cadwaladr University Health Board faces a number of service and performance challenges, which require ongoing support. The development of a clear and robust one year plan will form part of this, and will take place alongside the special measures work.

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 continue to work on developing an approvable 3 year plan.

Abertawe Bro Morgannwg University Health Board

ABMU has not been able to produce an IMTP that delivers service requirements and balances across the 3 year period of the plan. I recognise that this is disappointing for the organisation which has worked hard to produce an approvable plan and have clear ambition to deliver improvements. There are, however, specific concerns about performance, particularly in unscheduled care and cancer services. The organisation is producing a one year plan that focuses on improved delivery across a number of performance areas.  Officials will continue to work with ABMU to support them in their ambition to achieve a 3 year approval for 2017/18.

Cardiff and Vale University Health Board

Cardiff and Vale has requested some additional time in order to finalise their 3 year plan. I have therefore agreed with the Chair to defer my decision on their plan until the 8 July, in order for the organisation to have the opportunity to finalise work on some material issues in relation to their financial plan. I have asked my officials to provide further advice after that date.

The changes this year demonstrate the rigour of the approval process, and that organisations are required to continually meet their approval conditions throughout the rolling 3 year cycle.

Each of the 3 organisations who have not had approved plans will agree a one-year plan, which reflects key deliverables for this year and milestones for further development with the aim of achieving approvable medium-term plans in 2017/18.

The 3 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 to meet the commitments set out in their IMTPs. Where boards are unable to deliver approvable 3 year plans, my officials will consider appropriate arrangements to support them.