Welsh Ministers have made the Local Health Boards (Directed Functions) (Wales) (Amendment) Regulations 2026, signed on 16 January 2026 and commencing on 1 April 2026. The instrument amends the 2009 framework that directs functions to Local Health Boards (LHBs), extending it to cover direct payments within NHS Wales. The Regulations were made by Dawn Bowden, Minister for Children and Social Care, acting under the authority of the Cabinet Secretary for Health and Social Care.
From 1 April 2026, LHBs must exercise specified Welsh Ministers’ functions relating to direct payments for health care. This includes the functions in sections 10B(1) and 10D of the National Health Service (Wales) Act 2006, and the functions set out in the National Health Service (Direct Payments) (Wales) Regulations 2026. In practice, operational decisions on approving, making and managing direct payments will shift from the centre to NHS bodies locally.
The amendment inserts a definition of “direct payments” into the 2009 Regulations by cross‑reference to section 10B(8) of the 2006 Act. In statutory terms, direct payments are sums provided for the purpose of the health service in Wales so that care can be secured in line with the legal framework. Using the Act’s definition inside the 2009 scheme ensures consistent interpretation across all LHBs.
The direction to LHBs remains qualified. The exercise of these functions is expressly subject to regulation 5 of the 2009 Regulations and to any prohibitions or restrictions contained in an LHB Order. Boards will therefore need to apply the new duties within the existing limits of their establishment instruments and the standing direction architecture that already governs other NHS functions.
For patients and carers, the change provides a clear statutory route for access to direct payments through local NHS bodies rather than Welsh Ministers. Individuals should expect locally managed processes for considering applications, agreeing care arrangements and monitoring spend, with oversight structured by the new 2026 Regulations and the safeguards already present in the NHS (Wales) Act 2006.
For LHB executives and finance teams, the immediate task is to ensure capability to exercise the transferred functions from 1 April 2026. That includes having documented decision‑making procedures, payment controls, audit and reporting lines, and agreements with other bodies where appropriate under section 10D. Clinical governance, safeguarding and fraud prevention measures should be aligned to the new payment route.
The Explanatory Note confirms that a Regulatory Impact Assessment (RIA) has been prepared under the Welsh Ministers’ Code of Practice. The RIA sets out the likely costs and benefits of complying with the Regulations and is available from the Welsh Government at Cathays Park, Cardiff, and on gov.wales. Commissioners, providers and third‑sector partners should review it to understand expected implementation costs and assumptions.
The legislative backdrop is recent. Sections 10B to 10D were inserted into the National Health Service (Wales) Act 2006 by section 24(2) of the Health and Social Care (Wales) Act 2025. This amendment to the 2009 Directed Functions Regulations operationalises that primary legislation by placing day‑to‑day delivery of direct payments with LHBs, creating a single, locally administered route from 1 April 2026.