Written Statement: Update on progress made under special measures at Betsi Cadwaladr University Health Board

It has been just over nine months since I placed Betsi Cadwaladr University Health Board into special measures as a result of serious concerns about board effectiveness, organisational culture, service quality and reconfiguration, governance, patient safety, operational delivery, leadership and financial management.

I am today publishing the third progress report, which covers the work undertaken between September and November. This has been a challenging three months, and while there are real signs of positive change, there remains a lot of work still to be done.

I continue to meet the health board’s chair and senior team regularly and, during this three-month period, I visited a number of health board sites, including the Royal Alexandra Hospital, Abergele Hospital, Dolgellau and Barmouth Hospital, and a primary care medical centre and a pharmacy in Rhyl. The First Minister met the chair and chief executive in North Wales in September.

I want to thank all the staff at the health board who are working hard to make a difference to healthcare in North Wales. I also want to highlight some of the positive things I have seen over this three-month period, including:

• The appointment of Carol Shillabeer as the permanent chief executive, Gareth Williams as the vice chair and two new independent members.
• People with bowel cancer in North Wales are benefitting from faster recovery following surgery following the introduction of robotic technology. General surgeons are using the Versius surgical robotic system at Ysbyty Gwynedd for eligible bowel cancer patients.  
• Wrexham Maelor Hospital is the first in Wales to use a new procedure – a cutting-edge laser – to remove bladder tumours or suspicious areas. The procedure uses Trans Urethral Laser Ablation (TULA), an examination of the bladder using a camera on a thin flexible tube that uses a laser for bladder treatment. This will improve people’s outcomes and experience.
• Since launching the 111 Press 2 service in January, the health board has taken more than 8,000 calls from people who need urgent mental health support. Feedback has shown 99.3% of callers reported a reduction in their distress scores after contact with dedicated wellbeing practitioners. Referrals to local primary mental health support services have reduced by 8%.
• There has been a reduction in the number of long waiting patients at both the outpatient and treatment stage. The number of people waiting more than 52 weeks for a first outpatient appointment has fallen by 16.6% between February and September and the number with total waits or more than 104 weeks has reduced by 21.7% in the same period. 
• The focus on eliminating four-hour handovers at emergency departments is resulting in some improvements. There were 621 handover delays in excess of four hours in October 2023 – a 20% reduction compared to October 2022 and considerably better than the 1,042 in March 2023.

In September, I agreed additional funding to support the health board’s tele-dermoscopy project and last month, I approved a business case for a new orthopaedic hub at Llandudno Hospital. The health board has also received planning permission for a new mental health unit at Ysbyty Glan Clwyd.

The improvements in operational performance and quality and safety, while welcome, are not being made as quickly and effectively as possible. We need to see greater improvements in performance and these need to be sustained.  

I continue to be concerned about the findings highlighted by both HM Coroners and the Public Services Ombudsman. These include failures to act promptly with the complaints process; insufficient or ineffective strategic planning and support being undertaken; the timeliness of health board investigations and the continued reliance on paper patient records. This is an area where I expect urgent improvements to be made.

Alongside the progress report published today, I am also publishing our expectations for the next three months. I have been clear with the health board it must start to demonstrate tangible outcomes and sustainable improvement. I will provide a further report at the end of February 2024, reflecting on the first year of special measures.