Questions raised over “delay in implementing recommendations of such an important and far-reaching report”

A patient advocate would like to see Betsi Cadwaladr “working faster” after it emerged recommendations to improve mental health services from a damning report have taken almost seven years to sign off.

The comment came in response to news 19 recommendations from the controversial 2013 study into mental health by Robin Holden won’t be reviewed until the end of September.

The Holden Report, instigated by whistle-blowing staff, details allegations of neglect and how staff felt unable to cope on Hergest mental health unit at Ysbyty Gwynedd, Bangor.

In a letter to MS Darren Millar in November 2015 Simon Dean, interim chief executive at the time, said “we have taken action on or addressed” all issues.

Betsi Cadwaladr UHB’s Quality, Safety and Experience (QSE) committee was told last week “this work, due to the need to robustly validate the evidence, is aiming to be completed by the end of September for executive scrutiny”.

The health board said it was “incorrect to suggest” it had taken seven years to implement the recommendations.

Geoff Ryall-Harvey, chief officer of patient advocate North Wales Community Health Council (NWCHC),  was bemused by the hold up.

He said: “I would like to see the health board working faster. I find it difficult to understand the delay in implementing the recommendations of such an important and far-reaching report.”

The Holden report was kept under wraps by Betsi Cadwaladr for almost six years but was told to release the findings by the Information Commissioner’s Office (ICO) in June.

The board always claimed it doesn’t want to release the report because it may compromise the anonymity of staff who contributed.

The ICO rejected the board’s reasons for keeping it secret but in the QSE report discussed last week it said: “The Health Board has appealed this decision and a tribunal hearing is expected in early 2021.”

Despite its reluctance to release the material a copy did find its way into the public domain and reportedly catalogued a litany of staff concerns about care. Staff also reportedly felt intimidated by management and fearful of speaking out.

In the QSE report it said finally signing off the recommendations would “support the Health Board’s commitment to be open and transparent”.
It added: “(It) is aimed to provide confidence to the Board and our community that actions identified in the Holden Report (2013) were implemented and remain sustained at the current time.”

However in a separate update report about mental health and learning disabilities provision discussed at the same meeting, interim director of nursing Mike Smith brought up similar issues across mental health services as those contained in the Holden Report.

He said there had been “whistleblowing” reports to Healthcare Inspectorate Wales from the eastern region, a “lack of stability” within leadership due to temporary post holders and staff saying they don’t feel part of service of changes.

Teresa Owen, executive director of public health at Betsi Cadwaladr University Health Board, said: “Since the Holden Report was produced in 2014, there have been many reports to the Board outlining progress at the Hergest Unit.

“External reports from unannounced inspections of the unit by Healthcare Inspectorate Wales also show that standards of care, staff morale and leadership arrangements have improved in recent years.

“In order to provide assurance to the Board and the wider community that improvements made in response to the Holden Report and other reports have been sustained, we have commissioned a review which will be completed by the end of September.

“This will be reported to the Quality, Safety and Experience Committee at its next meeting in October 2020.”

By Jez Hemming – Local Democracy Reporter