Up to 700 people a month affected by Countess of Chester decision not to accept some patients from Wales

Health secretary Vaughan Gething has said it is “unacceptable” for the Countess of Chester hospital not to accept certain patients living in Wales.

As many as 700 people a month living in Wales – many from Flintshire – will be affected by the decision not to accept any new elective referrals for Welsh patients from the 1 April.

The move does not impact maternity patients, those attending the Accident and Emergency Department and patients from North Wales who are already waiting for treatment at the CoCH.

It does however relate to referrals in to all specialties, including urgent suspected cancer and both urgent and routine planned – known as elective – referrals.

In a statement today Welsh Cabinet Secretary for Health and Social Services Vaughan Gething, said;

“I have been very clear that the action taken is unacceptable and not in line with the statement of values and principles agreed between the NHS in Wales and NHS in England that we will act in the best interest of patients at all times.

Residents in Flintshire have a long history and relationship with the hospital.

Funding from treating patients from Wales has always been and continues to be essential to the viability of CoCH.”

The Countess of Chester hospital action relates to a significant change to the structure of the tariff system and rates that determine the amounts payable to provider trusts in England for treatment of patients.

This tariff system technically does not apply to cross-border healthcare but has previously been used as the basis for payment to provide consistency.

“The tariff rate changes agreed for 2019/20 by NHS England agencies include additional costs from staff pay deals that should not be chargeable to NHS Wales organisations.

To agree the financial impact for Wales, my officials have agreed a process of direct engagement with the Department for Health and Social Care officials, along with representatives from NHS Wales and the NHS England.” Mr Gething said.

Discussions have been “constructive” the health secretary has said, and “representatives from the NHS in England are considering the issues raised by Wales ahead of a further agreed meeting later in April.” He added.

“In light of the decision taken by the CoCH I immediately asked officials to engage with the UK Government Department for Health and Social Care.

We have requested it takes action to de-escalate the position and I will be following this up directly with Ministers in the UK Government this week.

My priorities are to urgently resolve this local issue and ensure we have robust and fair cross border payment arrangements agreed that has patient care at its forefront.”

Welsh Government officials have been “actively engaging” with Betsi Cadwaladr University Health Board (BCUHB) to ensure that “discussion and communication is taking place with partners and information and support is being provided to patients.”

BCUHB are putting in place interim systems and processes to ensure that patients receive the care they need.

Countess of Chester hospital chief executive Susan Gilby said the decision to not accept new elective referrals from Wales had been a difficult one for the board to take, but said it was necessary to address the ongoing funding issues.

She said: “Unfortunately, the trust is currently unable to accept any new elective work relating to patients living in Wales.

We will of course honour any existing appointments so there will be no disruption for patients already waiting.

This is a difficult decision that has been taken with great reluctance.

At the Countess we are mindful of our position close to the border, with many of our patients and staff coming from both England and Wales.

Unfortunately, this is a step we have had to take as a result of unresolved funding issues.

However, contract negotiations are continuing.”

Welsh Conservative Assembly Member for Clwyd West and Acting Health Spokesperson Darren Millar, commented:

“There can be no excuses for this debacle. The Welsh Labour Government wants to pay less for equivalent treatment than the UK Government yet receives £1.20 to spend on patients here for every £1 spent on patients over the border.

There is no capacity in North Wales to do this work so failure to resolve the matter will mean longer waiting lists for treatment and put patients at risk of worse outcomes.

The Welsh Government failed to pay the appropriate rates in previous years and has been repeatedly warned that a failure to do so this year would lead to the action which has now been taken.

The Labour Minister has the cash available to fund these referrals, for the sake of everyone in North Wales he should pay up an end this crisis immediately.”