Diolch, Llywydd. Further to my written statement yesterday, I wanted to take the opportunity to update Members on the range of actions underway to secure and sustain improvements both in maternity services and the wider quality and governance arrangements across Cwm Taf Morgannwg University Health Board.

Yesterday, I published a second update from the independent maternity services oversight panel. I'm sure that, across the Chamber, we'll be encouraged by the overall assessment provided by the independent panel that there has been good progress in implementing the recommendations made by the royal colleges following their review of maternity services that I ordered and reported last year.

Importantly, and in the words of the independent panel members, they are now cautiously optimistic that longer term, sustainable improvements will be achieved. The panel has assessed evidence that has provided them with reasonable assurance that a further 25 recommendations have been delivered since they last reported. This includes: improvements in both the quality and uptake of training for both medical and midwifery staff, underpinned by robust plans for continued delivery; having a comprehensive clinical governance framework in place that is resulting in improvements in clinical practice; improvements in the reporting, investigation and learning from serious incidents; and, very importantly, confirmation that the midwifery staffing levels, which the health board has been working to over the past nine months, are now in line with Birthrate Plus recommended levels.

The panel will revisit these and other areas periodically over the next six to 12 months to ensure that they're embedded in practice and improvements are therefore sustained, whilst also assessing progress against the outstanding recommendations.

Whilst I am encouraged to see these improvements in the safety and quality of clinical care, I'm particularly pleased by the positive feedback about the experience of care being reported by women and families who currently use services. In addition to the health boards' processes for capturing real-time experience, this feedback is also corroborated by findings from community health council visits over recent months. Furthermore, the recent inspection report from Healthcare Inspectorate Wales found that care was being provided in a safe and effective manner at the Tirion birth centre, which a midwifery-led unit at the Royal Glamorgan Hospital.

However, as the panel has made clear, there remains much more to do to build on this progress. I confirmed in my written statement yesterday that an important component of the panel's role is to undertake a programme of clinical reviews looking at the quality of care previously provided. This is important to ensure that all possible learning is identified and acted upon, but equally, to try to answer any outstanding questions that women and families may have about their care.

I'm grateful to the panel for the extensive work that has been undertaken to develop a robust and thorough process, supported by a large team of independent, experienced clinical reviewers who have now been recruited. They are and I am determined that women and families will be at the centre of this work and will be supported to be involved if that is their wish. Additional advocacy support is also being provided by the community health council to assist with this.

I was pleased to have the opportunity to meet with women and families last week, alongside the panel. Listening first-hand to their experience is always difficult, but it is essential to understand how we ensure sustainable improvements in the provision of high-quality, women-and-family centred services.  

Before Christmas, I also met with staff at both Prince Charles and Royal Glamorgan hospitals. They told me that they now felt that there was more coherence and credibility to the leadership and delivery of their service. I got a real sense of commitment, ownership and pride once more in the improvements that they were seeking to sustain and build upon. This, without doubt, has been a very difficult time for staff, and I want to thank them for what that they have achieved in a short period of time, and that has been clearly recognised by the independent panel.

Much of the learning from maternity services is now helping to shape wider organisational improvements. Since my last statement in October, Members will be aware that Healthcare Inspectorate Wales and the Wales Audit Office have published their joint review of quality governance arrangements. This highlighted a number of fundamental weaknesses in those arrangements, and the report makes wide-ranging recommendations to address them. However, I was also encouraged that they confirmed that the organisation's new leadership had fully recognised the challenges, the need for change and that much of that work is already well under way. This includes making changes to ensure their governance processes are robust, open and transparent, with clear lines of accountability and escalation when concerns arise.

There are a number of work streams under way to engage staff to address the concerns that have been raised around the culture within the organisation, together with those actions needed to rebuild patient, public and stakeholder confidence and trust. I particularly expect rapid and sustainable improvements to be made in how the organisation responds to patient concerns and complaints. This is essential to drive learning and improvement as well as being recognised as an organisation that is open and transparent in all that it does.

The various reviews that have now taken place and have reported over past months have provided a comprehensive picture and diagnostic of changes that are needed. That includes ways of working and the underpinning values and behaviours that are expected to ensure the quality and standards of care that everyone has a right to expect. I'm confident that the board fully recognises the seriousness of the issues and the scale of the challenge that they still face in achieving sustainable change and improvement, and they are considerable.

As I set out in my written statement last week on NHS escalation and intervention, the current levels of escalation remain in place across all NHS organisations. So, in Cwm Taf, maternity services remain in special measures and Cwm Taf Morgannwg remains in targeted intervention.

There are now clear improvement plans developing to respond to the range of changes required. My officials will continue to work closely with the health board to ensure they are both supported and challenged to deliver those improvements. Many can and must be achieved at pace, while others will take longer to achieve and embed to ensure sustainable improvement. I will of course keep Members updated on progress.