Back of queue threat for people who miss NHS appointments
It is one of a number of Welsh government ideas being discussed to improve the NHS, which has recently seen small reductions in record waiting lists.
The threat of sanctions would be balanced by an improved Welsh NHS app, which would allow patients to track their progress through the system and make or amend appointments at the touch of a button.
Health boards could also have their funding clawed back if they have been given extra cash to hit specific targets but do not make them. But this will not affect core health board funding.
The plans are being framed as striking a new deal between the NHS and patients, where there would be a greater expectation for patients to play their part.
In order to better manage waiting lists, there could also be increased levels of intervention to get patients fit for surgery, such as people being asked to lose weight or exercise more before they are placed on a waiting list.
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The way the NHS in Wales is led is also likely be streamlined – with the aim of making it simpler and more accountable – just two years after previous changes.
The NHS Wales Executive was established in 2023 as a "hybrid" body made up of NHS staff and civil servants with the aim of strengthening leadership and helping to transform clinical services.
But a highly critical Audit Wales report into cancer services earlier this year raised serious concerns about its effectiveness, with auditors finding "confusion and duplication " at leadership level and a "lack of clarity" about the responsibilities of the Welsh government and the executive.
The Welsh government is also thought to be considering commissioning at a national level for services provided by the private sector to try and get better deals, rather than what it sees as a local and last minute approach.
Health boards are expected to push back against the idea, but ministers are expected to argue the new proposal would lead to better planning and value for money.
Publishing a wider range of performance data for each of Wales' seven health boards is also being considered as part of a drive for greater transparency and accountability.
This would not be released in the form of league tables, but is aimed at introducing a greater sense of "competition" so health boards performing poorly in certain areas can learn and be judged against the best.
A panel of independent experts, which was commissioned in October to review the NHS, is expected to publish its findings at the end of April.
They are thought to have serious concerns about the effectiveness of performance management.
Health Secretary Jeremy Miles is expected to give more details on some of the proposals in the coming days.
They are understood to reflect a growing desire to get a grip with what's viewed as underperformance over a number of years, despite significant extra investment.
We'll prioritise NHS waits over reform, says Morgan
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