Written Statement: Special Measures, Betsi Cadwaladr University Health Board - quarterly progress report

I placed Betsi Cadwaladr University Health Board into Special Measures on 27 February because of serious concerns about board effectiveness, organisational culture, service quality and reconfiguration, governance, patient safety, operational delivery, leadership and financial management.

To ensure everyone is up to date with developments and progress made in the first three-month cycle between March to May. I am today publishing:

• The detailed Special Measures framework for March to December 2023
• A short summary of the Special Measures framework.
• The first quarterly report covering the period March to May 2023;  
• A short one-page summary of the work undertaken during these three months.

The Special Measures framework clearly sets out the reasons for the escalation of the health board and the areas where improvements need to be made. This will guide the Special Measures intervention for the rest of 2023.  It will be refreshed in January 2024 following an assessment of progress.

Placing a health board into Special Measures does not mean the Welsh Government takes over the day-to-day running of the health board. That remains the responsibility of the board.

I have appointed a new interim chair and independent members to work with the existing executive directors to form a new board. The Welsh Government’s role is to ensure the health board is properly led and governed, to provide continued oversight, and to ensure the required improvements are being made in the specific areas identified.

A Special Measures assurance board has been established, which is chaired by Welsh Government. It will support the health board in determining what steps are necessary to navigate an effective and sustainable route out of Special Measures.  The assurance board met for the second time on 26 May.  The assurance board will also advise me, through agreed governance channels, whether appropriate steps are being taken.

I want to be sure that the health board is improving vascular services, including implementing the recommendations of a previous review of services, and implementing new pathways of care and governance procedures.  On 29 June, Healthcare Inspectorate Wales confirmed it had de-escalated vascular services at the health board from a service requiring significant improvement in recognition of the progress the health board has made.  However, I remain concerned about vascular services at the health board and my officials are working with the health board and the NHS Executive to undertake an assurance assessment of vascular services.

The first quarterly progress report covers the work undertaken between March-May 2023. It has been a challenging three months; however, it is important to reflect on the good work being done across the organisation.  There are thousands of staff who live and work in North Wales, and who are committed to delivering the best possible patient care. We must give them the space and opportunity to do their jobs.

Some of the positive things that I have seen over the first three-month period include:

• Creation of a new board, including a new interim chair and six independent members working with the executive directors on developing as an integrated board.
• Cancer services in Betsi have historically been one of the best performing in Wales and it continues to outperform most other health boards.
• During a visit to Ysbyty Gwynedd, I had the opportunity to see the breast day unit where more than 90% of people are treated as a day case, allowing them to return home on the same day after life-saving surgery – this is fantastic.
• Occupational therapists in Flintshire and Wrexham are working from GP practices, reducing the waiting time by an average of nine weeks.  
• Three new specialist nurses have been appointed as the health board’s first metastatic clinical nurse specialists – supporting people with incurable secondary breast and colorectal cancer.
• The North Wales Adolescent Service (NWAS) has been awarded a kitemark for its work in embedding patient experience into the heart of the service. 
• A new stroke rehabilitation centre has opened in Deeside Community Hospital as part of a £3m programme to improve stroke care in north Wales. 
• The NHS 111 press 2 service for mental health is now available 24/7 in North Wales.
• A former activities room in the Morris Ward in Wrexham Maelor Hospital has been transformed into the Morris Café for dementia patients, complete with a ‘bus stop’ to give patients the feeling of going out.
• Between the end of January 2023 and April 2023, there has been a 37% reduction in the number of open pathways waiting over 52 weeks for a first outpatient appointment.

There are still improvements to be made, but these are encouraging signs for people living in north Wales. I will provide a further report on progress during the second three-month phase in the Autumn, and I will continue to update Members as the work progresses.