External Finance Support

Description

This contract commissions time-limited external support to assist Cardiff and Vale University Health Board in responding to a significant and worsening financial position while operating under Welsh Government oversight and escalation arrangements. The Health Board is forecasting a £56.2m deficit in 2025/26, compared to a £27.7m deficit outturn in 2024/25, and faces a material underlying financial gap in 2026/27 that cannot be addressed through business-as-usual savings alone. In the context of the 2026/27 planning round and the requirement to demonstrate a credible medium-term route to financial sustainability, the Board has agreed to commission independent support to identify the scale and nature of change required to alter the current financial trajectory. The purpose of the assignment is to develop a finite, decision-grade set of approximately five to seven high-impact options that explicitly set out what activity, services or sites would need to slow, stop, be consolidated, decommissioned or traded off in order to materially improve the financial position in 2026/27 and demonstrate a credible path to medium-term financial balance. The focus is on making the consequences of affordability explicit rather than developing narrative strategies, consensus or recommendations on preferred options. Each option must be articulated in granular operational terms, including affected services or sites, the nature of the change, workforce implications linked directly to service and activity change (including WTE impact), financial impact and phasing, delivery dependencies and constraints, and key risks and trade-offs including impacts on access, quality, safety and workforce. Options must clearly distinguish between what could realistically contribute in 2026/27 and what would deliver benefit in later years. The work will complement existing internal savings programmes, bring independent challenge and judgement, avoid optimism bias and untested productivity assumptions, and be delivered at pace within a tight timeframe. Outputs must be suitable for Board consideration and engagement with Welsh Government. The external support will provide analysis and option appraisal only, with all substantive outputs completed by no later than 31 March 2026.

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