I do understand that many will have been surprised by the findings of their report. However, anyone who has taken the time to read the report carefully should appreciate the thoroughness of the investigation and understand how the conclusions have been reached. In relation to the care on Tawel Fan the independent findings are that the levels of care and treatment provided on Tawel Fan ward were of good overall general standards and that good nursing was provided.

Whilst assurance can be taken from some of the findings, the report is a difficult read. It is far from a clean bill of health. I do not shy away from the significant issues it highlights across a number of areas, including governance and clinical leadership; service design and care pathways; and safeguarding. Many of the issues go beyond mental health services at the Tawel Fan ward.

HASCAS will be meeting individually with each family to discuss individual patient reports, which are crucial in providing the detail of the care provided. I hope that, alongside the thematic report, the individual reports will provide assurance to families about the integrity of the investigation. A similar process will also take place for staff who have been affected. I have already sought assurance that the health board is providing appropriate levels of support to both staff and families during this process.

As I have already stated, it is very clear that further, sustained improvement is still required by the health board. This will require further focused oversight under the special measures arrangements. 

The report does though acknowledge the considerable journey that the health board has embarked upon, recognising that it hasn’t stood still since the period being investigated. The report states the health board has made significant progress in key areas detailed in the dementia strategy, for instance, having a designated consultant nurse in dementia care. It also recognises the steady progress that Betsi Cadwaladr has made in relation to patient and carer support, and working proactively to support the care home sector.

The report also references many areas where they saw good practice. I am keen that, despite the criticism in the report, we recognise the excellent care provided by so many staff across the health board, both then and every day since the events that this report examined. For example, the nursing team on the Bryn Hesketh mental health in-patient unit have been shortlisted for an award that recognises those who have achieved excellence in their field of nursing. 

However, despite some positives, I continue to be very clear with the health board about the need to increase the pace of improvements and to deal with issues that are again highlighted in this report, and I will set out my expectations for that improvement. I will today publish a special measures improvement framework that sets out the milestones and expectations for the health bard for the next 18 months in leadership and governance, strategic and service planning, mental health and primary care, including out-of-hours services.

This improvement clearly references the work required by the organisation as a result of the recommendations from HASCAS. It may require a further update after Donna Ockenden’s governance review, which is expected shortly. This will take the form of a detailed quality and governance improvement plan to be prepared by the health board and to be available by the board’s July meeting this summer. I will continue to provide ministerial oversight with monthly accountability meetings with the chair and the chief executive. I expect Betsi Calwaladr to provide detailed progress reports against the new improvement framework and the first report will be provided in October this year.

Key to improvements is strong leadership for the organisation. I previously reported that a new chair will lead the next critical phase of the health board’s improvement journey. I am pleased to announce today that Mark Polin has been appointed to the role. He will bring a wealth of public sector leadership and governance experience, commitment to and knowledge of the communities of north Wales from his current role as the chief constable of North Wales Police. I will provide a further update on his appointment and the special measures arrangements in an oral statement in early June.

I expect strong leadership, and especially clinical leadership, from all parts of the organisation to address once and for all the issues that this report identifies. There must be a significant culture change to move from the current underlying resistance to clinical policy and consistency in practice. The board will need to give this rapid and serious consideration to determine what steps need to be taken to change ways of working. I expect, at the least, to see this demonstrated in clinical leadership and engagement to support the design and delivery of a care pathway for older people with dementia, together with the significant improvement in mental health provision that is still required.

I expect both the health board and local authority partners to carefully consider the findings in relation to the operation of safeguarding arrangements. Protecting people at risk from all forms of abuse and neglect is one of the key priorities of the Welsh Government. This is clearly reflected in the legislation and policy that we have introduced in this term and the previous one.

I expect the findings in this report to be used to hold a mirror up to all NHS organisations in Wales. I am therefore writing to all chairs and chief executives of NHS organisations in Wales, asking their boards to consider the report's recommendations and to confirm how they will use the findings to improve their organisation. I will also expect the chief medical officer and the chief nursing officer to engage with professional executive leads to ensure that lessons drawn from this report are embedded in the future planning and delivery of healthcare in Wales. These are immediate actions being taken in response to the findings of the HASCAS report. I will of course continue to update Members on the progress being made on the wider required improvement.