Finally, it has become clear that the health board's current systems are largely reactive. External reviews have pointed to significant gaps in fundamental aspects of clinical service standards. That includes record keeping, incident management, team working, reporting concerns, leadership and morale. Many processes are in place, but there is not sufficient capacity in place and they're not broad enough to provide systematic assurance in these areas. The health board must become a self-improving organisation, sustained by clinical staff with the skills to practice continuous improvement in their daily work. This focus needs to be evident right through the organisation, from ward to board.

I am asking the health board to do the following things: review current governance, audit and effectiveness capacity and work arrangements with Improvement Cymru to invest in a rapid education and support programme that will be put in place quickly in order to improve skills. I have also asked the health board to ensure that a senior appointment is made to a director of safety and improvement post. This individual will support the new executive director of nursing to ensure that joint governance improvements and arrangements are put in place across the health board. On top of this, the board must do better to connect with and engage with its staff and the public. There have been a series of concerns raised about workforce well-being, cases of harassment, bullying and staff feeling unable to speak out. The board must build on the work it has started in terms of its organisational development, and it must do this quickly. Given the seriousness and exceptional nature of this escalation, these arrangements will be monitored closely and reviewed early to ensure that progress is made. A further tripartite meeting will take place no later than the end of October this year. 

Dirprwy Lywydd, this is an extensive and far-reaching set of targeted intervention arrangements for Betsi Cadwaladr University Health Board, and we will review these regularly and robustly over the coming months. Let me be clear that there are pockets of brilliant work being done in Betsi Cadwaladr University Health Board. What we need to see now is that that quality is replicated across the whole system, most specifically in Ysbyty Glan Clwyd. But more importantly, this is a set of arrangements that will support the health board on its continuing improvement journey so that the people of north Wales can be proud of their local health service. Thank you.