Further savings and cuts may need to be found as Powys Teaching Health Board (PTHB) grapple with a deficit budget of just under £23 million – which could balloon to around £35 million.

The dire financial situation facing PTHB was discussed at a board meeting on Wednesday, September 25.

PTHB had initially planned to post a £24.9 million deficit budget this year, but in May they were asked by the Welsh Government to look at the figures again.

This saw the figure brought down to £22.9 million, which has yet to be agreed by the Welsh Government.

Five months into the financial year the report explained that the health board is £3.386 million adrift of where they should be.

The danger is that this could balloon to an over £12 million overspend on top of the planned deficit.

Director of finance, Pete Hopgood said: “There is a continued deterioration in our performance, this is very worrying and challenging, and we are asking budget holders to do what they can to reduce our run rate.”

Of the £9.9 million savings target this year Mr Hopgood told the board that £8.5 million is now forecast to be delivered.

He stressed that “month six” would be very important in terms of whether they could hold to planned deficit position.

PTHB chairman Carl Cooper asked: “Why are we finding ourselves in this position, why are we off plan?”

Director of planning performance and commissioning. Stephen Powell said that other NHS providers used by the health board to treat patients such as the Robert Jones and Agnes Hunt Orthopaedic Hospital at Gobowen near Oswestry, were taking on much more work at the start of the financial year than expected.

And from an emergency care perspective PTHB is seeing an increase in the length of patient stay in hospitals.

“This generates additional charges,” said Mr Powell.

Independent member Dr Rhobert Lewis said: “I want to highlight the delays.

“Yesterday we visited a word at Bronllys (hospital) 18 beds all full, but nine of those were for patients that needn’t be there.”

He added that this was not just creating a financial problem, but the stay will also cause a person to deteriorate physically.

Dr Lewis said: “The cost of delays last year was £5 million.

“The trajectory for this year looks like it will be £10 to £11 million or more, it’s a very alarming increase.

As the debate continued, fears were raised of a worst case scenario of what if the board could hold the £23 million deficit position and the Welsh Government did not give them more money.

Dr Cooper stressed: “We still don’t have a supported plan, and we need to hold on to that fact.

“We have not had any other formal message from the Welsh Government other than your £23 million forecast is unacceptable; you need to go further.

“We’re in a position where we’re saying that is not achievable and it might become £12 million or so more.”

Dr Cooper asked for the board’s consent to tweak the report recommendation so that it read: “The board is asked to recognise that, pending the outcome of the urgent action plans initiated to address the increased financial deficit, further options may need to be considered when finalising the month six financial position.”

This went further than just considering a change of year end forecast.

The board approved the report.