The Welsh health minister has set out a revised list of expectations required for North Wales’ crisis hit health board to finally exit special measures.
Betsi Cadwaladr University Health Board (BCUHB) has been under the highest level of Welsh Government monitoring for around four-and-a-half years following a damning report into failings on the Tawel Fan mental health ward.
Yesterday Vaughan Gething announced that the region’s maternity services and GP out-of-hours have been stepped down as special measures concerns after recent progress.
However, he also called for urgent improvements in several outstanding areas, including the number of patients facing lengthy waits in A&E departments.
It comes after a report was published last week in which Healthcare Inspectorate Wales demanded action over people being left on trolleys at Wrexham Maelor Hospital’s emergency department.
In a written statement, Mr Gething said: “The health board has already proven it can deliver on a number of improvement expectations.
“The immediate expectations the health board now needs to meet to be stepped down from special measures focus on planning, unscheduled and planned care performance and financial management.
“This framework is not a list of actions to tick off but a clear set of immediate and medium-term expectations for the health board to demonstrate progress to move down the escalation levels.
“Despite increased demand compared to the same period last year there has been a slight improvement in four-hour performance, but this falls short of expectations and remains weak from a comparative position.
“Further sustained action and the new initiatives introduced need to start showing further progress in reducing four- and twelve-hour waiting times.”
The health board has come in for strong criticism over the last month for spending money on a management consultant to help it deliver financial savings.
Concerns were raised after officials confirmed it was paying £1,990 a day for an “interim recovery director” at a time when it is facing an anticipated budget shortfall of £35m.
But Mr Gething defended the appointment in his statement.
He said: “I realise, over the last few weeks, there has been significant interest regarding the interim recovery director appointment. I fully recognise the rates of pay are significant.
“However, there is an urgent need, backed by the Public Accounts Committee findings, for the health board to address its financial position.
“Progress has been made since the recovery director started in post in developing a pipeline of opportunities to deliver their savings requirement.
“This is providing an increased level of assurance that the board will make progress and report an improved financial position compared to last financial year.”
Shadow Health Minister Angela Burns said she welcomed the news that two areas had been brought out of special measures.
But the Welsh Conservative AM criticised the fact other services were still waiting to see improvements.
She said: “I acknowledge the Minister’s confirmation that there has been a slight improvement in four-hour performance, but agree that this falls short of expectations and remains weak from a comparative position.
“The people of North Wales deserve better, as do the hardworking and talented nurses, doctors, physiotherapists and all other grades of front-line staff.
“All of them have, of course, not been waiting four hours, but four and a half years for improvements and to see BCUHB finally removed from special measures, and they are still waiting.”
The health board has now been asked by Mr Gething to undertake a self-evaluation of its current position.
It will be required to submit its findings to the Welsh Government by mid-December with a special meeting scheduled in the spring to discuss the next steps.
The health board’s chief executive Gary Doherty said: “We are pleased that the health minister has noted that progress has been made against the improvement framework.
“While there are areas where we perform well, for example in cancer services, we know that more needs to be done.
“We must deliver a number of significant improvements that have been set out by Welsh Government, including turning around our financial position and improving our performance on waiting times targets.”
By Liam Randall – BBC Local Democracy Reporter (more here on the LDR scheme).
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