New report highlights ongoing challenges at Betsi Cadwaladr despite leadership improvements

A new report by Auditor General for Wales has detailed the progress made by Betsi Cadwaladr University Health Board a year after it was put into special measures.

It comes 12 months after the Auditor General published a report in the public interest that described a worrying level of dysfunctionality within the board at Betsi.

The report highlighted a need for immediate action to address fractured working relationships between the health board’s senior leaders that were fundamentally compromising the board’s ability to tackle the substantial challenges the organisation faces.

Following significant changes to the board membership over the last 12 month a follow-up report published this week describes a board that is now more stable.

The appointment of a new Chief Executive is highlighted as a positive step forward – along with a noted improvement in working relationships among senior leaders.

The report also indicates that the dysfunctionality previously observed within the board is no longer evident.

However despite the improvements Wales’ largest health board continues to grapple with fundamental challenges, especially as it remains in special measures.

One aspect highlighted is the urgent need to finalise substantive appointments to the board to ensure its full capacity.

Additionally, efforts are ongoing to strengthen the Executive Team and address ongoing personnel issues within the Finance Department.

Further action in a number of areas is still needed – including work to build a cohesive and high performing executive team and to move as quickly as possible to a position where the board has a full complement of substantive executive directors and independent members.

Governance structures that were stood down in 2023 following the resignation of the previous independent members need to be built back up and the issues that led to the suspension of staff in the finance team need to be resolved, the the Auditor General states.

The report highlights the need for the organisation to develop its internal capacity and resilience to sustain improvement without requiring continual external support.

Auditor General, Adrian Crompton said: “It’s assuring to see that the dysfunction within the health board’s senior leadership that we described last year is no longer present.

“There is now a need for the board to build upon this progress and provide the unified organisational leadership that is needed to address the significant and on-going challenges facing the health board.”

Chair of Betsi Cadwaladr University Health Board, Dyfed Edwards said: “I welcome this report which acknowledges the progress the health board has made over the past year.

“I fully understand that there is much more to be done as we continue on our improvement journey in order to ensure excellent healthcare services for the people of north Wales.”

“I see the Audit Wales report as a milestone to show we are moving in the right direction.

“Over the last 12 months we have worked to create stability and a positive and supportive culture within the health board, whilst focusing on quality of service provision and reaching out to patients and the public we serve.

“We now have a firm foundation to build on, with a new Chief Executive and new Board members in place who are committed to improving our governance, our financial management and ultimately improving our focus on quality and the experience of the patient and their families.

“I am grateful for the support of our partners and Government in all our efforts.”

Responding to Audit Wales’ report on Betsi Cadwaladr University Health Board, Plaid Cymru spokesperson for Health and Social Care, Mabon ap Gwynfor MS said: “While we welcome the progress that has been made to improve Betsi’s board compared to a year ago, this report shows that Betsi should never have been taken out of special measures in the first place.”

“It was a premature and convenient decision by Labour to show progress in health services across north Wales for electioneering purposes, only to place the health board back into special measures two years later after a series of failings.”

“However, the Labour Government must now work with the health board and provide clear timescales for the outstanding actions to be completed – to appoint a full board of Executive Directors and Independent Members.”

“We need clear evidence that the Government has learnt its lesson and that we can move past the normalisation of dysfunctionality and falling standards that’s taken place at Betsi over the years.

“Labour must commit to avoiding taking the board out of special measures prematurely which would undo the progress that has been made, and to be transparent about how they act upon advice provided by the other parties to the tripartite process.”

“Ultimately, their priority must now be to deliver for the people of north Wales.”

 Shadow Minister for North Wales, Darren Millar MS, said: “The Betsi Cadwaladr University Health Board is nearing yet another anniversary in special measures, but patients and staff are yet to see the improvements they have been promised by Labour Ministers.

“Report after report highlights problems yet the Welsh Government seems incapable of getting to grips with the failings and problems they expose.

“We need an independent inquiry into the mess in our NHS in North Wales to restore public confidence and deal with these issues once and for all.”