Powys patients face longer waits for English treatment
Patients from Powys may have to wait longer for operations in English hospitals under plans to save money.
Many patients need treatment across the border because the county does not have a large hospital.
But they could have to wait at least 32 weeks under plans by Powys Teaching Health Board to save £2m this financial year.
According to Welsh government targets, only 5% of patients should spend more than 26 weeks on a waiting list.
The Welsh government said it expects everyone to be seen within its targets, which require 95% of patients to be treated within 26 weeks and for all patients to be treated within 36 weeks.
Powys Teaching Health Board said it will comply with the maximum 36 week "backstop" for non-urgent cases.
But it has written to a neighbouring NHS trust in England to say it will only pay for treatment carried out in a 32 to 36 week "window".
Powys's finance director told a board meeting in September that while there was a commitment to the 36-week limit, the board would be "utilising flexibility".
The move could save the board £2m in this financial year, according to minutes of the meeting.
In a letter to an NHS trust in Shropshire, seen by BBC Wales, Powys finance director Rebecca Richards says the board has decided to "extend the referral to treatment time (RTT) for its residents from 26 weeks to a maximum of 36 weeks, noting that no patients wait longer".
The letter to the Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust in Oswestry adds: "What this means in practice is that we will allow a four-week window within which we expect patients to be treated and therefore RTT completions before 32 weeks and post 36 weeks will not be funded."
Shopshire trust chief executive Wendy Farrington-Chadd confirmed it had been informed to "increase the waiting times for Powys patients from 26 to 36 weeks for the remainder of the financial year".
She said the trust was working with Powys health boards and any urgent cases will continue to be prioritised.
In a statement, the health board said: "Powys Teaching Health Board is currently performing at above 98% against the 95% target for 26 weeks, however this level of performance is achieved at a significant cost.
"Within this context, a degree of slippage can be tolerated and the health board has taken steps to utilise the flexibility within the 95% target whilst still meeting it."
The Conservative AM for Montgomeryshire, Russell George, called on Health Minister Lesley Griffiths to intervene.
"I have had constituents coming to my office in tears, because effectively they have been told they are going have to wait a further 10 weeks, and remain in that discomfort and pain over that period," he said.
"The issue we have got is that we have a hospital in England treating English patients in 18 weeks, but cannot treat Welsh patients before 32 weeks.
"I think it is appalling."
A Welsh government spokesman said: "Officials have spoken with Powys Health Board and received assurances that there is no intention to move away from this policy and any providers within England that have received letters will be contacted to make this situation absolutely clear."