All seven health boards in Wales failed to meet their statutory duty to break even over a three-year period, an Audit Wales report has revealed, as it becomes “increasingly difficult for NHS bodies to produce financially balanced plans in the current climate of cost pressures and service demand.”

The report from the Auditor General for Wales Adrian Crompton outlined that health services in Wales received £10.638 billion of revenue funding in 2023-24 - a cash uplift of £744 million.

“This was significantly higher than the uplift of £131 million in 2022-23,” the report said.

“With the impact of rising inflation, the 2023-24 cash uplift equated to a 1.2 per cent real terms increase in funding.

“Against a backdrop of significant demand, the total in-year deficit for 2023-24 has increased to £183 million (£150 million in 2022-23) and the three-year cumulative over-spend across the NHS increased from £248 million in 2022-23 to £385 million in 2023-24.

“NHS bodies are having to deliver significant levels of savings in their attempt to contain costs. “Reported savings increased again in 2023-24 and at £210 million are at the highest level since 2018-19.

“Sound strategic planning is key if the NHS is to deliver services which are clinically and financially sustainable.

“However, none of the health boards were able to secure approval for a three-year integrated medium-term plan for 2023-26 from the Cabinet Secretary for Health.

“It is proving increasingly difficult for NHS bodies to produce financially balanced plans in the current climate of cost pressures and service demand.”

Mr Crompton said: “Whilst I recognise the scale of the financial and operational challenges faced by the NHS, I am concerned at once again having to qualify my audit opinion on the accounts of all seven Health Boards because they have failed to meet the statutory duty to break even over three years.

“The growing cumulative deficit for the NHS in Wales demonstrates that despite record levels of investment and higher than ever levels of savings, the statutory framework put in place by the Welsh Government to drive financial sustainability in the NHS is not working.”