GWENT'S health board broke even during 2014/15 despite the year being described by its finance chief as "volatile and uncertain."

Late confirmation of more than £20 million of extra funding from the Welsh Government as part of a Wales-wide NHS cash injection helped Aneurin Bevan University Health Board avoid a multi-million pound overspend, recording a small surplus of £438,000 against an annual budget of more than £1 billion.

But it has already reported a deficit of £2.4m against its forecast spend for April, the first month of the current financial year, and has identified a series of spending issues that need to be brought under control if the 2015/16 books are to be balanced.

Much of the aforementioned extra money from the Welsh Government was expected, based on previous years' NHS funding patterns, though it came later than usual.

But even with it, most other health boards in Wales required yet more help to stay within budget, though Aneurin Bevan University Health Board did not.

Director of finance Alan Brace said he hoped the health board had proved it could manage its finances responsibly and that this would hold it in good stead regarding potential support for key investments in the future.

"(2014/15) was volatile and uncertain for funding and these factors made it one of the most difficult years," he said.

"We have delivered within the resources given to us over the six years of this health board's existence."

The financial result for April however, is an indication that the pressures that have dogged health boards across Wales in recent years show little prospect of easing, at least in the short term.

A key factor in the April overspend in Gwent was the continued high use and cost of agency nursing staff to meet demand.

The bill was almost £1m in April, but was similarly high in February and March, with the health board struggling to fill ward and other nursing rotas. It is currently seeking to recruit new staff and to boost its own nursing 'bank' as a less pricey alternative to the use of agencies.

Other financial pressures are being created by continued high demand in emergency departments, a growing need for often expensive packages of Continuing Healthcare for (largely) elderly patients, and extra spending on orthopaedic surgery to bring down long waiting times.

These are among the high spending issues that must be addressed as soon as possible.