A £77 million deficit is being forecast by Gwent’s health board for 2020/21, as it seeks to plot a course for the reintroduction of services in the shadow of coronavirus and what promises to be a very difficult winter.

Uncertainty over how the ongoing threat posed by coronavirus is going to play out is making financial planning difficult in the NHS, and not just in Gwent.

Health boards and NHS trusts across Wales and the rest of the UK will be grappling too with the prospect of huge end-of-year deficits.

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The common theme is that great unknown - what will be the impact of coronavirus going forward? Will there be a second wave and if so, how big will it be? And how will that translate into extra capacity - beds, staffing, testing, personal protective equipment (PPE)?

As the Argus reported yesterday, with the initial extremely challenging surge of coronavirus countered, Aneurin Bevan University Health Board Board is seeking to step up the reintroduction of routine treatments and diagnostic tests.

But it is doing so at the same time as having to count the cost of dealing with that first coronavirus surge, while building capacity to try to be ready for what the disease may do in the future.

A big part of the planning involves ‘surge capacity’ which, for the period to the end of September, involves almost 700 beds, including 85 in critical care.

There is also a proposed extra 380 acute beds at the Grange University Hospital, if the health board’s wish to open its flagship new site near Cwmbran in November is approved by the Welsh Government.

A decision on that is still pending, but the forecast additional cost of doing so - instead of next spring as originally planned - is put at £17 million.

Surge bed capacity is put at £5 million, Gwent’s contact tracing programme at £10.7 million, with associated pathology testing at £5 million.

The potential commissioning of elective treatments and diagnostic tests at other health board or more likely through the private health sector is put at £3 million.

Other costs contributing to the forecast deficit are for medical and surgical supplies and equipment, including PPE (£7.9 million), and for schemes to support patients’ discharge from hospital (£2.5 million).

There is then the huge potential cost of extra staff to enable the delivery of all these projects, including the equivalent of more than 500 full-time staff for the Grange University Hospital for the period of its earlier than planned opening, and the equivalent of an average 940 full time temporary staff for every month of 2020/21.

The forecast deficit is likely to fluctuate as the year progresses, based on the future impact of coronavirus and its linked effect on staffing and bed numbers.

There have been savings too as a consequence of far less elective treatments and tests having been carried out since March, and being planned henceforth, and further funding from the Welsh Government will likely be forthcoming.

The deficit figure also includes millions of pounds already spent on preparing for and tackling the initial wave of coronavirus - but it sheer size is another stark indication of the impact coronavirus is having.