Swansea Bay’s health board plans to cut around 800 jobs over the next three years as it tries to claw its way back to a balanced budget.
The plan was set out at a special meeting of the board this week, held to sign off the previous year’s accounts and approve a fresh submission to the Welsh Government on its spending plans.
The board said it was forecasting a deficit of £76.6m for the coming year, 2026-27, meaning it expects to spend that much more than it receives. That is underpinned by a savings target of £65m.
That £76.6m is a forecast for the year ahead alone. It is separate from the £112m the board overspent across the three years to 2025-26 — a figure confirmed at the same meeting, when auditors signed off the board’s accounts with a formal warning over its repeated failure to live within its budget.
Those accounts also revealed that the board’s bill for clinical negligence claims had more than doubled in a year, and that it had needed a £74m Welsh Government bailout it will not have to repay.
The board said it was now working towards a return to a balanced budget by 2028-29, the end of a three-year recovery period.
Workforce director Tina Ricketts told the meeting the board had committed a year earlier to reducing its headcount by around 900 full-time equivalent posts, but that this had since been revised down to 800.
She said the overall savings value from pay was unchanged at £44.7m.
The board did not say which services or hospitals the reductions would affect.
However, Ms Ricketts said much of the saving would come from reducing spending on what the NHS calls “variable pay” — temporary staffing such as agency and bank workers brought in to cover shifts and fill gaps, rather than permanent jobs.
Bank staff are workers, often the board’s own employees, who pick up extra shifts as needed, while agency staff are hired through outside firms, usually at a higher cost.
She said 550 of the planned reductions would come from the board’s substantive, permanent workforce, with the remaining 250 from variable pay.
The board is one of the largest employers in the region, with a workforce of more than 13,000.
Its workforce has grown in recent years, which the board has acknowledged as one of the pressures behind its deficit. The savings it now needs to find are also rising — last year’s target was £55.4m, against £65m this year.
Chairwoman Jan Williams told the meeting the board now had more nurses than ever before, having in recent years filled vacancies through an overseas recruitment drive.
The planned reduction comes at a time of growing concern over NHS jobs in Wales. Earlier this year, Welsh student nurses warned they faced unemployment after qualifying, while 82 newly qualified paramedics were left without posts, prompting the Welsh Government to call an emergency summit.
Interim finance director Claire Osmundsen-Little said the board had drawn up a more detailed plan than its earlier attempts, which had been sent back by the Welsh Government, and that she was more confident it could reach a balanced budget by 2028-29.
She said the board had identified ideas it believed could save £181m over three years — slightly more than the £177m it needs to find — but cautioned that many of these were still proposals rather than confirmed savings.
The board remains in what the NHS calls Level 4 escalation — the highest level of Welsh Government intervention — meaning ministers have stepped in to monitor it closely because of concerns over its finances and performance.
Chief executive Abigail Harris told the meeting the board’s journey towards a sustainable financial position was “challenging,” and that progress was “not as quick as we would like.”
She said the board was tightening its grip on how budgets were set and spent, and holding managers to account for the money they controlled.
Because the board is still running a deficit, it is not allowed to formally sign off a three-year plan that does not yet balance. Instead, members agreed to send the Welsh Government further detail on how they intend to get there.
The board’s own performance and finance committee, which scrutinises its spending, said it took assurance from the work done — but flagged continuing concerns, including very little evidence so far of the savings actually being made, and questions over whether the board had enough staff and expertise to drive the changes through.
At the meeting, only £16.7m of this year’s £65m savings target had reached the more confident stages of planning.
The board also acknowledged that its cancer performance had been “disappointing,” and said it would bring a fuller update on its cancer improvement work to its July meeting.
The same meeting also heard the board apologise again over failings in its maternity care, as it responded to the national review of maternity services in Nottingham.
The board’s financial troubles come amid continued local concern over its services, including the future of Gorseinon Hospital.
The board said it would report in more detail on its recovery plan at its July meeting.
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