Investigation launched after £122m allegedly not properly accounted for by Betsi Cadwaladr

An investigation has been launched after it was found that around £122m worth of expenditure by Betsi Cadwaladr University Health Board could not properly be accounted for.

It follows an audit being carried out of the North Wales health board’s 2021-22 accounts which identified a number of significant errors.

Audit Wales said the health board was allegedly unable to provide sufficient audit evidence to demonstrate the existence of £72 million of expenses incurred but not paid in the year.

Auditors said there was also insufficient evidence to confirm that expenditure of £122 million occurred in the year or was properly accounted for in the correct accounting period.

The health board commissioned accountancy firm Ernst Young to undertake an external review of the circumstances that led to the errors identified.

NHS Counter Fraud Service Wales is now investigating the matter whilst Audit Wales is also undertaking a separate high level review of board effectiveness.

A separate investigation is also taking place into “working relationships at a senior leadership level” within the health board stated after concerns were raised through the NHS Wales Raising Concerns Policy about governance and leadership.

What has Audit Wales said?

An Audit Wales spokesperson said: “The Auditor General issued a qualified ‘true and fair’ opinion on the health board’s 2021-22 accounts in August 2022, because he could not obtain sufficient evidence that certain figures were accurately stated and accounted for in the correct accounting period.

“He also qualified his ‘regularity’ opinion because the health board again failed to meet its financial duty to break-even over a three-year period, and (along with eight other NHS bodies in Wales) incurred irregular expenditure in year in complying with a direction by ministers to fund clinicians’ pensions tax liabilities.

“The audit of the health board’s 2021-22 accounts identified significant errors. The health board was unable to provide sufficient audit evidence to demonstrate the existence of £72 million of expenses incurred but not paid in the year.

“There was also insufficient evidence to confirm that expenditure of £122 million occurred in the year or was properly accounted for in the correct accounting period.

“The health board stated that they did not have capacity to support the further audit work necessary to fully explore these issues, and consequently a ‘limitation of scope’ qualification was placed on the health board’s accounts.

“As a result of the issues arising from the audit of accounts, the NHS Counter Fraud Service is carrying out further investigation work.”

What has the health board said?

A spokesperson for Betsi Cadwaladr University Health Board said: “EY (Ernst and Young) have completed an external review of the circumstances that led to the Auditor General’s qualified opinion of the Health Board’s 2021-22 financial accounts.

“NHS Counter Fraud is now carrying out an investigation, which was requested by Audit Wales, and a small number of staff from our finance department are currently taking a leave of absence.

“As I am sure you will appreciate, we have a duty of care to our staff and no further comment will be made while this investigation is ongoing.”

Welsh Conservatives ‘deeply concerned’ by investigation

Welsh Conservative Shadow Health Minister, Russell George, said: “I am deeply concerned at the reports that huge sums of money are unaccounted for in Betsi Cadwaladr’s accounts and that there is another investigation into the senior leadership and their ‘working relationships’.

“There seems to be a new disheartening story every week regarding issues to do with the health board’s performance.

“This does seem to me like another episode of the Labour Government burying bad news over the Christmas period with these investigations.

“What Betsi Cadwaladr Health Board needs, is good leadership, accountability and stability to prevent these problems.”