• Trusts say millions of pounds of income at risk in dispute over tariffs with Welsh government
  • Comes after one trust refuses to treat Welsh patients
  • Trusts and Welsh health board say dispute will not further disrupt flow of patients across border

Hospital trusts along the Welsh border are at risk of losing millions of pounds this year, as a cross-border dispute over tariffs drags on.

Three trusts and a clinical commissioning group have identified financial risks of between £1.2 and £1.75m for 2019-20 if an agreement cannot be reached between NHS England and NHS Wales over tariff prices. Several other trusts have also expressed concerns over the dispute, without specifying a sum.

NHSE increased national tariff payments to trusts for 2019-20. These increases were not mirrored by the Welsh government, which argued it had not been funded to pay for such a rise. In effect, this means English NHS trusts are paid less for providing the same treatment to Welsh patients, creating a financial shortfall.

Earlier this month, the BBC reported Countess of Chester Hospital Foundation Trust had refused to treat Welsh patients until the dispute over meeting this shortfall was resolved – a move the Welsh government called “unacceptable”.

No other trusts have said they will block Welsh patients’ access to treatment.

However, in its April board papers, Wye Valley Trust said the ongoing funding dispute between NHSE/Improvement and the Welsh government meant about £1.5m in funding from Powys Teaching Health Board was at risk for 2019-20. Annually, the trust receives about £17m – nearly 10 per cent of its total income – from Welsh health boards.

The paper stated: “As the trust is assuming 100 per cent payment of this sum, it is a material unresolved risk in the finance plan.”

In response to questions, both the trust and the health board said they were confident the dispute would be resolved and would not disrupt “cross-border flow” of patients.

Board papers from Alder Hey Children’s Hospital FT also highlighted an “outstanding risk” of £1.75m if the dispute was not resolved. Before the decision not to treat Welsh patients, Countess of Chester Hospital FT said it was expecting to miss out on £1.2m through being paid less to treat Welsh patients.

Last month, Bristol, North Somerset, and South Gloucestershire Clinical Commissioning Group highlighted a risk of £1.3m associated across the region, which covers University Hospitals Bristol FT and North Bristol Trust. Both trusts treat a high volume of Welsh patients.