THE NHS in Gwent must save an eye-watering £48 million this year just to break even, despite having saved more than £140m in the past three years.

Health bosses running a budget of more than £1 billion are braced for another tough year of trying to deliver waiting times and other targets for patients, while ensuring balance sheets do not tip into the red.

A major programme of savings will try to keep the purse strings tightened, the emphasis more than ever on controlling spending early on, so Aneurin Bevan Health Board is not faced with having to close a bigger deficit in the second half of the financial year, thus putting even more pressure on services.

As in previous years, it is likely that an element of not filling vacancies, where appropriate, will contribute to savings, and there will an ongoing programme of reductions in the use of expensive agency staff, particularly in nursing.

The health board aims to save £6m on a range of prescription savings, with tighter management of medicines and prescribing playing a significant part.

A shift to, again where appropriate, cheaper generic drugs, and close monitoring of prescribing guidelines issued by the National Institute for Clinical Excellence, are among proposals.

Another move will be to send fewer patients, particularly in orthopaedics, outside of Gwent for operations.

Operating theatres coming on-stream at Ysbyty Ystrad Fawr will provide extra capacity, part of an overall plan for treatments intended to save close to £5m.

A similar amount is being targeted from savings in providing Continuing Healthcare – often complex packages of care provided in patients’ homes – while re-organising services and wards should realise £2.5m.

Gwent is not alone in Wales in having to find tens of millions of pounds of savings, and the extent of savings targets indicate the pressure on spending generally.

The Gwent situation is compounded, however, by the need to repay a £4.5m loan from the Welsh Government, required to break even at the end of 2011/12.

EDITORIAL COMMENT: Take care with cuts

IT ALWAYS gives cause for concern when public sector services have to make significant savings.

So the news that the Aneurin Bevan Health Board is having to cut £48m from its planned spending this year just to break even, is naturally worrying.

This is no small sum and it will not be easy for the decision- makers to decide where the cuts will come.

The health board’s problem is compounded by the fact it is having to pay back a £4.5m loan from the Welsh Government needed to break even in the last financial year.

But the need to make such major savings is also an indication of the pain being felt by all public-sector organisations across the UK.

The government’s determination to cut public sector spending has been well documented.

But it is now that all talk of cuts is having to be put into action. And local authorities and health services are facing the reality of a future with less money.

We do not have any wish to make their job even more difficult than it already is.

But part of our role is to scrutinise public bodies and we will be watching to make sure that front line services are as protected as far as possible when the knife starts to fall.

The health board may have to be creative in the way it addresses the problem as the needs of patients are paramount.