October 20, 2025 - 165 views
Health bosses in North Wales have been blasted for a “travesty” that cuts funding by more than £5,000 a year for care home residents receiving complex nursing care.
Betsi Cadwaladr University Health Board is paying less for patients in Conwy who need the most complex nursing care, despite them receiving round-the-clock support – including end-of-life-care - from highly qualified staff.
According to Kevin Jones, who has run the 38-bedroom Bryn Marl Care Home in Llandudno Junction for the past five years, the situation is “scandalous” and said it exposed a postcode lottery in how care is funded across Wales.
The six North Wales local authorities pay among the lowest fees in Wales but Conwy Council broke ranks and increased their funding to a level that makes them the sixth most generous in Wales.
Newport Council tops the table for support but Conwy’s neighbours Denbighshire are 21st and Gwynedd 20th with Wrexham Council rock bottom in 22nd place.
The majority of care home residents who need nursing care are on Funded Nursing Care (FNC) which is paid by local councils who are then reimbursed by the relevant health board.
But when a resident’s needs become more acute and complex they move to a different care package called Continuing Health Care (CHC) which is paid directly by the health board.
When Conwy Council increased their FNC funding they actually overtook the CHC fees provided by the Betsi Cadwaladr University Health Board
Kevin Jones said: “Conwy Council increased our FNC fees but they have overtaken the CHC fees paid by the Board so that residents who move to CHC funding are receiving less than they were before their condition deteriorated.
“That’s despite the fact that they may well need help eating and drinking, be in more danger of developing pressure sores and receive more specialist nursing care because as a person approaches the end of life their needs increase dramatically and they may have very complex issues.
“If they are assessed by the Health Board as needing CHC we will receive £1,217.23 a week from the Board – that’s £108.52 less a week than we were getting before, £5,643 less a year – it just doesn’t make sense.
“Their nursing needs have increased massively but their funding has actually gone down.
“When Conwy Council broke ranks with the other North Wales local authorities and increased their rates to a very realistic level we actually stopped charging the top-up fees which we had introduced.
“If we see someone’s condition deteriorating we have to ask the Health Board to review them but at the same time we know that we will be receiving less money while at the same time providing a greater level of care.”
Thea Brain, North Wales Policy Advisor for Care Forum Wales, said: “The big issue here is that Betsi Cadwaladr doesn’t have a proper methodology for determining the fees – it’s back of a fag packet maths.
“Other health boards, particularly in South Wales, do. Aneurin Bevan Health Board in Gwent takes the local authority fee and adds to it on the basis of specialist advice it commissions.
“Betsi Cadwaladr needs to adopt a proper methodology because what we have at the moment is a shambles and it’s not fair to the care providers and most importantly the fragile, seriously unwell people for whom they provide care.
“Most of them in Wales are small businesses, often family run, with one or two care homes and they’re doing their best to provide an essential service in their local communities.
“What is needed is a single, standardised methodology for calculating the level of care home fees with perhaps an additional Cardiff-weighting taken into consideration to reflect higher prices in the capital in the way London is more expensive than elsewhere in the UK.”
Mario Kreft MBE, Chairman of Care Forum Wales, said: “The fact that funding should reduce so sharply when a person’s care needs are far more acute defies all logic. It is utterly ridiculous.
“We are talking about people, really frail elderly people who are seriously unwell and the way they are being treated by the health board is nothing short of shameful.
“Not only is it demonstrably unfair, it is totally unjust and builds in even more inequality into a system that is already unfit for purpose.
“All this is on top of the postcode lottery of funding that means you have vast discrepancies paid by local authorities and health boards in different parts of Wales.
“With the notable exception of Conwy, five of the six local authorities are at the bottom or near the bottom of the pile when it comes to funding
“It is no more expensive to provide a bed in a care home in Gwent than it is in Wrexham and yet care providers in in Gwent receive on average £1,014 a week per patient, £180 more than a similar care home in Wrexham.
“There is a growing chasm between the fees paid by councils in the north compared to the majority of authorities in South Wales and this North-South divide is essentially treating our care home residents - who are by and large extremely frail and vulnerable - like second class citizens.
“Conwy Council were brave enough to break ranks with the rest of the cartel in North Wales and now their care home residents are literally paying the price for Betsi Cadwaladr’s failure to properly fund the care of the most vulnerable in our society.
“Social care is clearly seen as an area where those commissioning services feel they can cut costs and make savings at the expense of these elderly and infirm people and the dedicated staff who look after them.
“The people making these decisions should take a long hard look at themselves. How would they feel if this was one of their loved ones?
“The way Betsi Cadwaladr Health Board is treating vulnerable people is way outside the norms of human decency and it’s high time they did the right thing for a change.”
