Written Statement: Governance Arrangements in Cwm Taf Morgannwg University Health Board

Members will be aware that Healthcare Inspectorate Wales (HIW) and the Wales Audit Office (WAO) today published their joint review of quality governance arrangements at Cwm Taf Morgannwg University Health Board. This report has highlighted a number of fundamental weaknesses in the health board’s governance arrangements in respect of the quality of care and patient safety. It also chimes with key findings from a number of previous reports and reinforces why it was necessary to increase the escalation status of the health board to targeted intervention earlier this year.

As the report makes clear, while some things can be done quickly and are already progressing, there is clearly still a considerable amount of work required to address the fundamental issues which have come to light. I am pleased that the health board has fully accepted the findings and recommendations and already taken considerable steps to address them. They have also committed to do this in an open and transparent way, as they have recently demonstrated with the action they took to review and improve their waiting list management.

The health board have stated their determination to embed a strong focus on quality and safety throughout the organisation. Actions already underway  include a significant focus on engaging with staff in developing a set of core values and behaviours to shape the organisational culture; implementing a new operating model and associated structures, ensuring clear lines of accountability; and strengthening processes to ensure robust  quality governance and risk management. But there is clearly much more to do. The health board’s progress is, and will continue to be, monitored closely through our escalation arrangements to ensure the necessary rigor and pace. I will continue to keep Members updated on progress and will issue a further statement on this and maternity services early in the New Year.

There will also be important reflection and learning for all NHS in organisations in Wales from this report. I have written to all NHS Chairs and Chief Executives today asking them to consider their own quality governance arrangements and review these against the report’s recommendations.

There are also a number of other actions in train to ensure robust governance arrangements are in place in all Boards. This includes a new approach to Independent Member Induction which will be mandatory for all new appointees. The programme will re-enforce the importance of the role of the Independent Member as a public appointee. It will also help develop their skills in providing scrutiny and seeking assurance as a board member.  In addition I have requested a review of the Code of Conduct for Boards and NHS Managers to re-enforce the standards expected of them as Board Members. Whilst recognising the collective responsibility for governance of the Board and organisation, I am also committed to strengthening the role of the Board Secretary as the guardian of good governance within NHS organisations in Wales.