North Wales Hospital Crisis Deepens After Care Home Residents Hit By Cuts

A social care champion has warned that a lack of fair funding from Betsi Cadwaladr University Health Board is worsening the crisis in hospital discharges in North Wales.

Mario Kreft MBE, the chair of Care Forum Wales, said care homes are being left to shoulder “real terms cuts” when the nursing needs of care home residents become more complex and serious.

According to Mr Kreft, the situation is a “travesty” and a “betrayal of the most vulnerable people

In a letter sent to all Members of the Senedd in North Wales, Mr Kreft said the 4.72 per cent increase offered by the BCUB for Continuing Health Care funding for 2025-26 was the lowest of any health board in Wales – and far short of what was needed to meet rising costs.

The plight facing seriously ill care home residents in Conwy was, he said, particularly stark.

The majority of residents who need nursing care are on Funded Nursing Care (FNC) which is paid by local councils who are then reimbursed by the relevant health board.

But when their needs become more acute and complex they move to a different care package called Continuing Health Care (CHC) which is paid directly by the health board.

In Conwy, there’s now a £5,000 a year drop in funding when that transition happens.

Care Forum Wales are due to meet health board officials on November 6 to try and find a way forward.

The issue, he said, had been brought into sharp focus by news that “significant and urgent” improvements were needed to the way the health board was run.

A new report on BCUHB, which remains in special measures, revealed that “expected improvements in operational delivery are not yet being realised”.

One of the areas for major concern is the way Continuing Health Care is funded.

Mr Kreft said: “It is a significant issue, not least because it’s causing ever more serious delays in hospital discharges with people being marooned in hospital when they shouldn’t be there.

“At the heart of this matter is the health and wellbeing of our most vulnerable people and what we need is fair funding to ensure that they received the best and most appropriate care.

“If we can unlock this problem, it will also have massive benefits for our hospitals in North Wales and the patients queuing up in ambulances outside because there are no beds available.

“There are thousands of beds in care homes which are a bit like mini community hospitals and they could and should be used to alleviate the pressure on the NHS.

“It’s clear from this new, depressingly familiar report that the dysfunction within the health board is still a major issue.

“They need to work with the social care sector and appreciate the value of the brilliant service provided by care homes in North Wales.

“By focusing on cost  instead value, the current short-sighted approach will come back to haunt them and have disastrous consequences for our most vulnerable people.”

In the letter to Senedd members Mr Kreft said the current situation was “completely unacceptable” and that 4.7 per cent increase funding from the health board didn’t even cover the additional National Insurance contributions that employers are now required to pay.

He added: “We’re seeing health boards elsewhere in Wales recognising these pressures with uplifts closer to six per cent.

“Our analysis shows a 7 per cent increase is needed just to stand still. Anything less is effectively a cut — and that’s unsustainable for local care homes.”

Mr Kreft said the failure to adopt a recognised national system for calculating CHC fees, such as Care Cubed or Laing & Buisson, had led to “perverse outcomes” like the situation in Conwy.

“We’ve seen people’s needs become more serious, yet the funding goes down. That’s a travesty,” he said. “It defies logic and sends entirely the wrong message about how we value the most vulnerable people in our communities.”

The row comes amid growing concerns about hospital discharge delays which health chiefs have repeatedly blamed on difficulties in finding community placements for patients who are ready to leave hospital.

Care Forum Wales said the situation has been made worse by BCUHB’s refusal to negotiate meaningfully with providers.

“We are six months into the financial year and no real progress has been made,” said Mr Kreft.

“Despite our repeated attempts to engage constructively, we’ve encountered intransigence from officials who appear to regard the 4.72 per cent offer as final.

“We want to reset the relationship on a more positive footing. The vast majority of care homes in North Wales are small, family-run businesses rooted in their communities.

“They want to help relieve the pressure on the NHS — but they can’t do that if they’re being forced to run at a loss.

“What should happen is that the health board works in true partnership with the care homes in North Wales.

“They should appreciate the value of these important community services which can allow thousands of hospital patients to be discharged, which is the best solution for all concerned, most importantly for the people for whom we provide care.”