Following the tripartite meeting between the Welsh Government, Healthcare Inspectorate Wales and Audit Wales, the NHS chief executive has recommended that the targeted intervention status at Betsi Cadwaladr University Health Board should be extended beyond mental health and governance issues to incorporate Ysbyty Glan Clwyd, focusing in particular on the vascular service and emergency department in Ysbyty Glan Clwyd, and I have accepted that advice. They did not suggest that we put Betsi back into special measures.

We will therefore ensure that significant new additional external clinical and practical expertise will be put in place to ensure that we embed sustainable change and improvements in the quality of the service. In this way, we'll be making improvements with the health board rather than doing things to the health board. The decision has been made in line with the escalation framework and reflects serious concerns about the leadership, governance and progress that have been a feature of Ysbyty Glan Clwyd. My decision has been communicated to the chair of the health board.

Firstly, let me address the issue of governance, leadership and oversight of Ysbyty Glan Clwyd. It's clear the current challenges facing Ysbyty Glan Clwyd require a focused intervention to support cultural change and promote leadership at all levels. I have therefore instructed Improvement Cymru, the improvement service for NHS Wales, to work with the health board to bring in external clinical and organisational development expertise into the hospital. The aim of Improvement Cymru is to support the creation of the best quality health and care system for Wales, so that everyone has access to safe, effective and efficient care in the right place and at the right time. I want to emphasise that this in no way reflects on the hard work of the staff in Ysbyty Glan Clwyd, but this is a source of external help and support to embed the change that is needed urgently, and we need to do this at pace.

Secondly, vascular services have been challenged since the service was centralised. This does not mean that the decision to centralise was wrong. Following a series of concerns raised by the Royal College of Surgeons and Healthcare Inspectorate Wales, the health board has responded rapidly and progress has been made in a number of areas, but the service remains fragile. There have been some serious incidents over the last few months and the benefits of the recent changes have not yet been realised. A new clinical leader has been appointed but has yet to take up post. My officials will continue to monitor the implementation of the action plan at least twice a month.

Thirdly, the emergency department at Ysbyty Glan Clwyd has been designated a service requiring significant improvement by Healthcare Inspectorate Wales. We have made £3 million available to the health board for the local six goals for urgent and emergency care programme. I have instructed clinical leads from the national programme to work closely with the health board to address the concerns identified by HIW.

Fourthly, mental health. This service is, without doubt, in a much better state than the one that went into special measures. But, while progress has been made, there is still much more to be done, particularly around culture change, and this will take time. Following discussions with the Deputy Minister for Mental Health and Well-being, I'm asking the health board to move with pace to ensure that there is a permanent leadership team in place, and to develop a robust recruitment plan to minimise vacancies and the use of interim staff. We must make this a sustainable service. I have asked Welsh Government officials to commission an independent assessment of the sustainability of the progress that has been made against the various mental health reviews over recent years, and ministerial oversight of these arrangements will be led by the Deputy Minister for Mental Health and Well-being.