4. Statement by the Minister for Health and Social Services: Update on special measures arrangements at Besti Cadwaladr University Health Board

Part of the debate – in the Senedd at 3:27 pm on 24 November 2020.

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Photo of Vaughan Gething Vaughan Gething Labour 3:27, 24 November 2020

Thank you, Deputy Presiding Officer. Members will be aware that health boards and trusts in Wales have their escalation and intervention status considered as part of our joint escalation and intervention arrangements. This involves Welsh Government officials meeting with Audit Wales and Healthcare Inspectorate Wales twice a year to discuss the overall position of NHS Wales organisations in respect of quality, service performance and financial management. A wide range of information and intelligence is considered to identify any issues to inform their assessment and advice to me as the health Minister. There is also an opportunity to hold additional meetings, if the group deem it necessary.

At the last full tripartite meeting held in September, it was agreed to hold a further meeting before the end of the calendar year, specifically on Betsi Cadwaladr University Health Board. I am pleased to say that a special tripartite meeting took place earlier this month. The clear advice and recommendation to me was that the escalation status of the health board should change. I have accepted that advice. I have decided that Betsi Cadwaladr University Health Board will come out of special measures with immediate effect. The escalation status of the health board has now moved to targeted intervention.

The tripartite group reviewed further evidence submitted by the health board that demonstrated progress over recent years, including on the areas that had originally been designated as special measures concerns. The group noted that the health board has demonstrated improved engagement with partners, particularly during the current pandemic. It also recognised the level of insight shown by the health board into the challenges that it still faces, together with the determination demonstrated by the board and the incoming chief executive to make further progress.

The tripartite group noted the detrimental impact the special measures designation was having on the health board’s ability to recruit and retain staff, particularly at senior level. This has led to a number of the executive director roles currently being filled on an interim basis. This is, obviously, not helpful for the health board in moving forward. Special measures was also having an impact on the health board’s ability to make the necessary further progress.

There continue to be concerns on some aspects of performance, particularly in mental health services and the ability of the health board to prepare an approvable medium-term plan. Going forward, to provide the clarity and assurance of the necessary focus, a maturity matrix approach will be used, similar to the processes that have been in place in Cwm Taf Morgannwg University Health Board.

On 3 November, I announced a package of support for the health board. This support amounts to a further £82 million per year over three and a half years to support the health board as it enters a new phase under targeted intervention, and continues its ongoing work to improve. The chair of the health board has already responded outlining how this support will be utilised to improve unscheduled care, to build sustainable planned care, including orthopaedics, to deliver improvements in mental health services and, of course, to benefit the health of the population of north Wales.

It should be remembered that targeted intervention is still a heightened level of escalation. This requires significant action on the part of the organisation, and will be accompanied by a level of continued oversight from my officials. However, the move out of special measures marks an undeniably positive step forward for the staff of the health board who have made and sustained the progress to end special measures. This is also of course a positive step forward for every community in north Wales that is served by the health board.

I hope that Members across the Senedd will join me in congratulating staff at the health board as they move into the next phase of their improvement journey.