The board is paying over £5,000 a year less for residents in Conwy receiving Continuing Health Care (CHC) despite these patients requiring complex, round-the-clock nursing and end-of-life care.
Kevin Jones, who runs Bryn Marl Care Home in Llandudno Junction, said the situation exposed a postcode lottery in health and social care funding across Wales.
“Residents whose conditions deteriorate are now receiving less funding than before, even though their needs are greater,” he said. “It just doesn’t make sense.”
Conwy Council recently raised its Funded Nursing Care (FNC) payments, overtaking the CHC fees provided by the health board. As a result, when residents move from FNC to CHC a higher level of clinical support care homes are actually paid £108 less per week, or £5,643 less per year.
Jones said the policy had forced homes to deliver “more intensive care for less money,” despite caring for residents with acute and end-of-life needs.
“When someone’s condition worsens, we must ask the Health Board to review them,” he explained. “But we know that means receiving less money while providing a greater level of care.”
‘A Shambles and a Disgrace’
Thea Brain, North Wales Policy Advisor for Care Forum Wales, criticised the health board’s approach, accusing it of lacking any clear methodology for setting fees.
“Betsi Cadwaladr doesn’t have a proper system – it’s back-of-a-fag-packet maths,” she said. “Other health boards, particularly in South Wales, use structured models based on specialist advice. What we have here is a shambles that punishes care providers and fragile, seriously unwell people.”
She called for a standardised national framework for determining care home fees, with adjustments for regional costs similar to a “Cardiff weighting.”
‘A System Unfit for Purpose’
Mario Kreft MBE, Chair of Care Forum Wales, described the situation as “shameful” and said it reflected a wider North–South divide in care funding.
“It defies logic that funding should fall when a person’s needs become more complex,” he said. “This is demonstrably unfair and builds more inequality into an already broken system.”
Kreft noted that five of the six North Wales councils remain among the lowest funders in Wales, with Wrexham at the bottom of the table. He said the difference in funding meant care homes in Gwent receive on average £180 more per patient per week than those in Wrexham.
“Conwy was brave enough to break ranks,” he added. “Now their residents are paying the price for the health board’s failure to fund care properly.
The way Betsi Cadwaladr treats these frail and elderly people is outside the norms of human decency. It’s time they did the right thing.”
