NHS Wales 2019-20 Key facts

NHS Wales2019-20Key facts

The Auditor General for Wales' opinion is that the financial statements give a TRUE and FAIR view of NHS Wales' finances, but four Local Health Boards failed to meet their financial duty to break-even over a three-year period.

The NHS (Wales) Summarised Accounts sets out the combined financial results of all 11 Welsh NHS bodies as at 31 March 2020, whose accounts were published in early July

Audit findings provided assurance on

Total Funding £8.4 billion
How are they funded?
  • Funding from the Welsh Government £8.1 billion
  • Other income £0.3 billion

Funding covers general running costs and asset purchases, and has increased by £0.6 billion compared to last year

Total Spending £8.7 billion
How much did they spend on general running costs?
£8.3 billion
How much did they spend on assets purchases?
£0.4 billion
Primary Healthcare Services £1.5 billion
Payments to GPs£559 million
Payments to pharmacists£133 million
Payments to dentists£189 million
Payments to ophthalmologists£43 million
Costs of drugs dispensed£536 million
Other£45 million
Healthcare from other providers £0.9 billion
Non Welsh NHS bodies£289 million
Local Authorities£102 million
Voluntary organisations£54 million
NHS Funded Nursing Care£44 million
Continuing Care£371 million
Private providers£61 million
Hospital, Community & SHA £5.9 billion
Employee Costs£4,067 million
Supplies & Services£842 million
Premises£223 million
Other costs£740 million
What they own £5.2 billion
Total Assets£5,240 million
Hospitals, transport, equipment and other assets£3,644 million
Amounts due from the Welsh Government £1,273 million
Cash Balances£82 million
Medical and other supplies, including drugs£85 million
Other amounts due to the NHS£156 million
What they owe £2.2 billion
Total Liabilities£2,240 million
Amounts put aside for ongoing claims for medical negligence£1,125 million
Other amounts owed by the NHS£1,115 million

Amounts paid out during the year on medical negligence claims was £106 million

Staff Costs £4.2 billion Staff numbers 83,800
Of which, Salaries and wages £3.3 billion, split
People Wage cost
81,000 £3,119 million
300 £23 million
2,000 £138 million
500 £58 million
Financial duties NHS Accounts Tool
Financial duties met
  • Aneurin Bevan
  • Powys
  • Cwm Taf Morgannwg
  • Public Health Wales
  • Velindre
  • Welsh Ambulance Services
  • Health Education and Improvement Wales
Financial duties not met

... with accumulated deficits of £354 million over the last three years

  • Betsi Cadwaladr
  • Cardiff and Vale
  • Hywel Dda
  • Swansea Bay


The finances of NHS Wales were brought together in one set of accounts for the first time in 2019-20.
Three health boards in Wales overspent for the fourth year running. Some positive progress but the NHS Wales 2019-20 deficit was £89 million (2018-19 £96 million).
In July 2020, the Health Minister announced that when each of the four health boards achieves their three-year break even duty, their historic deficits will no longer be repayable. Link to statement
Betsi Cadwaladr has remained in special measures since June 2015, with outstanding concerns relating to governance, finances and specific performance areas. Cwm Taf Morgannwg remained in special measures for maternity services. Link to Betsi Link to Cwm Taf
Additional funding allocated to NHS Wales for Covid-19 related expenditure up to 31st March 2020 was £15.491 million, and the scale of expenditure in 2020-21 is unprecedented. Link to COVID 19 statement
A Ministerial Direction in December 2019 instructed the Welsh Government to fund certain pension tax liabilities for NHS clinicians. No additional costs resulted in 2019-20, but the Auditor General has drawn attention to a contingent liability for future costs reported in the accounts. Link to Ministerial Direction
NHS WALES Includes
7 Local Health Boards
  • Aneurin Bevan
  • Betsi Cadwaladr
  • Cardiff and Vale
  • Cwn Taf Morgannwg
  • Hywel Dda
  • Powys
  • Swansea Bay
3 NHS Trusts
  • Public Health Wales
  • Velindre
  • Welsh Ambulance Services
1 Special Health Authority
  • Health Education and Improvement Wales
Primary care services

Healthcare services that you can find in your community, outside of hospital

Healthcare from other providers

Healthcare services that are provided by other organisations, not NHS Wales

Hospital, Community Health Services
    This relates to expenditure on
  • Healthcare services that are provided in hospital
  • A wide range of community services, such as district nursing and palliative care, and health promotion services such as school nursing and health visiting
& by Special Health Authorities

This relates to expenditure incurred by Health Education and Improvement Wales, who have a leading role in the education, training, development and shaping of the healthcare workforce in Wales

Amounts due from the Welsh Government

The Welsh Government will reimburse NHS Wales for any medical negligence claims that are more than £25,000

Special measures

the highest level of escalation that happens where there are concerns that the NHS body needs external support to respond to the serious concerns identified

Ministerial Direction

this is a formal instruction from Welsh Ministers telling the Permanent Secretary to proceed with a spending proposal

Contingent liability

this is a cost that may occur depending on what happens in the future, but the amount cannot be determined at this time

Staff Costs £4.2 billion

staff costs include salary and wages of £3.3 billion, pension costs of £0.6 billion and social security costs of £0.3 billion

Financial duties

Health Boards and NHS Trusts are required to breakeven over a three-year rolling period. The Special Health Authority is required to breakeven each year

Cardiff and Vale

Cardiff and Vale achieved breakeven for the year, but a cumulative three-year deficit means it failed its target