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Written Statement - Betsi Cadwaladr University Health Board: special measures improvement framework

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The Wales Audit Office and Healthcare Inspectorate Wales have worked closely with the Welsh Government to develop and agree the arrangements.
Vaughan Gething, Deputy Minister for Health

Following the advice of Healthcare Inspectorate Wales (HIW), the Wales Audit Office (WAO) and senior Welsh Government Officials, I confirmed, on October 22, 2015, that Betsi Cadwaladr University Health Board would remain in special measures for two years.

I am today publishing the improvement framework for the health board, which sets out our expectations for improvement in each of the areas identified under special measures and the milestones for progress over the next two years. It also sets out the criteria Betsi Cadwaladr University Health Board must meet in order for special measures to be considered for de-escalation in the future.

The process to develop the framework has included feedback from HIW, WAO the health board and advice from the team of independent expert advisors who have worked with the board during the first months of special measures. 

Betsi Cadwaladr University Health Board is making progress, although the scale of change is significant and regaining the trust and confidence of the local population and staff will take time. It is therefore important that the milestones set for the health board, against which it will be assessed, contribute to the development of that trust.
Special measures is a new concept for the NHS in Wales, however it has been used in a number of NHS organisations in England. We have drawn on the experience in England, which has shown that it can take a number of years for organisations to be successfully transformed.  

The improvement framework identifies actions Betsi Cadwaladr University Health Board will take to demonstrate and evidence progress of improvement in each of the areas identified under special measures – leadership and governance; engagement with the public and staff; mental health; maternity services; and primary care including out-of-hours services. Progress against the framework will be considered at the regular tripartite meetings by HIW, WAO and senior Welsh Government officials.

The health board must now respond and demonstrate how it plans to deliver the expectations outlined in the improvement framework, ensuring it achieves the timescales in each of the three phases – up to six months; seven to 12 months and 13 to 24 months. It will provide evidence of progress against the first six months in May.

Betsi Cadwaladr University Health Board has recruited a new chief executive, Gary Doherty, who will take up post on 29 February. He will provide long-term leadership to take forward the action required and continue the process of rebuilding the relationship with and confidence of staff, public and stakeholders. 

Simon Dean will continue to act as the interim chief executive and the accountable officer until Mr Doherty’s arrival. He will then return to his substantive role as deputy chief executive of NHS Wales. I would like to thank Mr Dean for providing leadership during the immediate months of special measures and his work to stabilise Betsi Cadwaladr University Health Board. I also thank the health board’s staff for continuing to respond positively to the special measures arrangements.

The Welsh Government will continue to provide extra resources and support through the improvement team to work alongside Betsi Cadwaladr University Health Board while it remains in special measures.