Welsh government seeks talks with Westminster over border dispute

Ministers in Wales have branded the trust’s decision as “unacceptable” and suggested it is “not in line” with the best interests of patients.

As previously reported, the Countess of Chester NHS Foundation Trust (CoCH) has stopped accepting any new elective referrals for Welsh patients from the 1 April.

The decision relates to referrals in to all specialties, including urgent suspected cancer and both urgent and elective referrals.

The move does not, however, affect maternity patients, those attending the accident and emergency and Welsh patients who are already waiting for treatment.

In a statement issued on yesterday, Welsh health minister Vaughan Gething said:The level of monthly elective referrals from Wales to CoCH is around 700 patients.

“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,” he said.

“Residents in Flintshire have a long history and relationship with the hospital,” he said. “Funding from treating patients from Wales has always been and continues to be essential to the viability of CoCH.”

”I immediately asked officials to engage with the UK government Department for Health and Social Care”

Vaughan Gething

Mr Gething noted that the trust’s decision was sparked by significant changes to the tariff system that determine the amounts payable to trusts for treatment of patients.

The 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 include additional costs from staff pay deals that should not be chargeable to NHS Wales organisations.

In order to agree the financial impact for Wales of the tariff change, Mr Gething said his officials had prevously agreed a “process of direct engagement” with the Department for Health and Social Care, along with representatives from NHS Wales and the NHS England.

He highlighted that these discussions had been “constructive” and that representatives from the NHS in England were considering the issues raised by Wales ahead of a further agreed meeting later in April.

Betsi Cadwaladr University Health Board

‘Real time’ monitoring of HCAIs in Welsh hospitals

Vaughan Gething

But he said: “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,” said Mr Gething.

He added: “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.”

He also said that government officials had been actively engaging with Betsi Cadwaladr University Health Board to “ensure that discussion and communication is taking place with partners and information and support is being provided to patients”.

The health board was also ”putting in place interim systems and processes to ensure that patients receive the care they need”, said Mr Gething.