Key Facts: NHS Wales Finances 2020-21

The Auditor General for Wales' opinion is that the financial statements give a True and Fair view of NHS Wales' finances.

However, four local health boards have failed to meet their financial duty to break even over a three-year period.

The NHS (Wales) Summarised Accounts sets out the combined financial results of all 11 Welsh NHS bodies as at 31 March 2021. These comprise seven local health boards, three NHS trusts and one special health authority.


This is the second year the finances of NHS Wales were brought together in one set of accounts, after being presented this way for the first time in 2019-20.

Two health boards in Wales overspent for the fifth year running. Some positive progress, with the NHS Wales deficit falling from £89 million in 2019-20 to £48 million in 2020-21.

Additional funding allocated to NHS Wales for COVID-19 related expenditure up to 31 March 2021 was £1.3 billion. The scale of expenditure in 2020-21 is unprecedented. Our data tool shows how this and other income and expenditure is broken down

Link to data tool [Opens in new tab]

Funding and Spending

How NHS Wales is funded?
£9.40 billion Funding covers general running costs and asset purchases
£9.60 billion
Hospital, community and special services £6.9 billion
Employee costs £4,670 million
Supplies and services £1,033 million
Other costs £841 million
Premises £388 million
Primary healthcare services £1.6 billion
Payments to GPs £590 million
Costs of drugs dispensed £569 million
Payments to dentists £172 million
Payments to pharmacists £139 million
Other £47 million
Payments to ophthalmologists £43 million
Healthcare from other providers £1.1 billion
Continuing care £416 million
Non-Welsh NHS bodies £311 million
Local authorities £186 million
Private providers £78 million
Voluntary organisations £52 million
NHS funded nursing care £49 million

Staff Costs

£4.8 billion
How much NHS Wales spent on staff
Role Number of staff Cost
Permanent staff 84,513 £4,475 million
Agency staff 2,292 £157 million
Specialist trainee staff 690 £36 million
Other 590 £69 million
Staff on inward secondment 326 £25 million

What they own

£5.6 billion

What they owe

£2.8 billion

Financial Duties

Financial Duties met:

Aneurin Bevan
Cwm Taf Morganwwg
Health Education and Improvement Wales
Public Health Wales
Welsh Ambulance Service

Financial Duties not met:

...with accumulated deficits of £235 million over the last three years

Betsi Cadwaladr
Cardiff and Vale
Hywel Dda
Swansea Bay

Further Highlights

On 3 November 2020, the then Minister for Health and Social Services announced a package of strategic assistance funding for Betsi Cadwaladr University Health Board of £82m a year over a three and half year period to cover their annual deficit, to support improvements to planned and unplanned care and mental health services and to build broader capacity and capability in the organisation. This preceded the Ministerial announcement of 24 November 2020 to de-escalate the Health Board from Special Measures to Targeted Intervention
Following a Ministerial Direction in 2019 instructing the Welsh Government to fund certain pension tax liabilities for NHS clinicians, the Auditor General has once again drawn attention to a contingent liability for future costs reported in the accounts.
Of the £1.3 billion COVID-19 funding provided, £186 million was for field hospitals, £194 million for personal protective equipment and £28 million for the COVID-19 vaccination programme.