Wales hands NHS direct payments to LHBs from April 2026
From 1 April 2026, your Local Health Board will run NHS direct payments in Wales. A new Welsh Statutory Instrument amends the 2009 ‘directed functions’ rules so boards, not ministers, take on the day‑to‑day decisions and arrangements. The instrument was signed on 16 January 2026 by Dawn Bowden on behalf of the Cabinet Secretary for Health and Social Care. This change sits on top of the Health and Social Care (Wales) Act 2025, which brought direct payments for health care into law on 1 January 2026. (legislation.gov.uk)
Quick definition you can teach with: direct payments are cash sums the NHS can give to a patient (or a nominated person) so that they can organise support the NHS would otherwise arrange. Welsh law says this requires the person’s consent, and it also says people must be offered information, advice and support to use the money well. The Act also lets Local Health Boards be enabled, by regulations, to make certain direct payments themselves in after‑care under the Mental Health Act. (legislation.gov.uk)
What the 2026 regulations actually do: they add a new rule telling Local Health Boards to exercise specific Welsh Ministers’ powers on direct payments. In plain terms, boards must carry out functions under section 10B(1) of the 2006 Act (the power to make direct payments), section 10D (letting boards or ministers arrange help with those payments), and any detailed rules in the forthcoming NHS (Direct Payments) (Wales) Regulations 2026. That exercise is still limited by regulation 5 of the 2009 regulations and by any restrictions set in each board’s establishing order. (legislation.gov.uk)
Who these boards are and why they are being asked to do this: Local Health Boards plan and deliver NHS services across Wales and can be directed by ministers to exercise ministerial functions for their areas. This is set out in the NHS (Wales) Act 2006 and explained in accessible guidance on Law Wales. In short, Wales uses boards rather than English‑style commissioners, so handing delivery to LHBs fits the devolved model. (legislation.gov.uk)
A short primer on Welsh SIs for your class: a Welsh Statutory Instrument is a piece of secondary law that fills in detail beneath an Act. It is ‘made’ when signed, but it only ‘comes into force’ on the date set in the instrument. Since 1 January 2026, all Welsh SIs must be laid before the Senedd, and the scrutiny procedures have updated names (approval, confirmation, annulment). Knowing these terms helps you read dates and procedures correctly. (senedd.wales)
What this means for you if you receive Continuing NHS Healthcare: from April you will deal with your Local Health Board about whether a direct payment is right for your care plan. By law, consent is required; you should be offered information and support; and regulations can set conditions, including when payments may stop or be recovered if misused. Welsh Government has already signalled the aim is to extend choice and control for eligible people. (legislation.gov.uk)
Study prompt for students and early‑career teachers: map the ‘enabling power’ in the 2006 Act to the action taken by ministers and then to what Local Health Boards must do. Then check the Regulatory Impact Assessment (RIA) Code to understand how the Welsh Government weighs costs and benefits when it makes subordinate legislation. This is how devolution looks in practice. (gov.wales)
Where to look next: the detailed do’s and don’ts will live in the NHS (Direct Payments) (Wales) Regulations 2026. Welsh Government consulted on how boards should make and manage health direct payments, including who can receive them and how support services might work. If you’re teaching this topic, compare those proposals with the final rules once published. (gov.wales)
One last checkpoint when reading the law: the 2009 regulations keep a standing rule that boards cannot themselves make new Orders or Regulations; they act within powers given and any limits in their establishing orders. That helps explain why ministers needed a fresh SI to point boards at the new direct payment powers created by the 2025 Act. (legislation.gov.uk)