All seven health boards in Wales, including Aneurin Bevan University Health Board which covers Gwent, failed to meet their statutory duty to break even over a three-year period, according to a report from the Auditor General.

The three NHS trusts and two special health authorities in Wales, however, all met their duty to break even.

ABUHB had a deficit of £49,766,000 for the 2023-24 financial year up from -£36,842,000 for 2022-23. It broke even before that.

The health board had made £42,985,000 in savings in the last financial year, made up of £27,891,000 in recurring savings and £15,095,000 in one-off savings.

Spending on agency staff decreased in 2023/24 to £42,649,000 from £61,177,000 in 2022/23, which was the highest figure in five years.

Health services in Wales received £10.638 billion of revenue funding in 2023-24, a cash uplift of £744 million, which was significantly higher than the uplift of £131 million in 2022-23.

With the impact of rising inflation, the 2023-24 cash uplift equated to a 1.2 per cent real terms increase in funding (compared with a 4.9 per cent real terms decrease in 2022-23).

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, continuing the trend in 2022-23, and at £210 million, are at the highest level since 2018-19.

Auditor general Adrian Crompton said: 'While 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. 

"While there remains an urgent need for NHS bodies to continue to drive out cost inefficiencies in the way they work, this alone is unlikely to return the NHS to financial balance.

"More fundamental challenges now need to be grasped around the shape and infrastructure of the NHS, the level of funding it needs, its workforce challenges and how the demand for its services can be better managed.

"These are issues that should exercise the minds of politicians, government officials and NHS bodies and their partners in equal measure."