WIREDGOV

Health and Social Services Minister Mark Drakeford has yesterday set out the special measures Betsi Cadwaladr University Health Board is subject to following its failure to make sufficient improvement against long-standing concerns about governance, leadership and other issues.

The Minister announced recently that the health board had been placed in special measures, following an urgent meeting of the Welsh Government, Wales Audit Office and Healthcare Inspectorate Wales (HIW) to review Betsi Cadwaladr University Health Board’s escalation status.

Following the Minister’s decision, Betsi Cadwaladr University Health Board has this morning confirmed that it had suspended it chief executive with immediate effect.

The Minister has asked Simon Dean, deputy chief executive of the Welsh NHS and chief executive of the Velindre NHS Trust, to assume the responsibilities of accountable officer at Betsi Cadwaladr University Health Board with immediate effect. Mr Dean will oversee arrangements to provide health services in North Wales with longer-term leadership.  

The Minister has also set out a number of areas in which tangible improvement must be demonstrated as part of the special measures regime:

• Governance, leadership and oversight – the health board must implement governance and assurance actions which have been highlighted in a series of reports, including by the Wales Audit Office and HIW, and in a review carried out by Ann Lloyd. The Ann Lloyd report will be placed in the public domain yesterday 
• Mental health services – the board must implement the mental health plan for North Wales, including actions arising from previous reviews, governance concerns and significantly the recent report into the events at Tawel Fan
• Maternity services at Ysbyty Glan Clwyd – the health board must resolve the outstanding question about the future of consultant-led maternity services at Ysbyty Glan Clwyd, acknowledging the ongoing quality, safety and service sustainability issues and bring forward plans for the SURNICC
• GP and primary care services, including out-of-hours services – the health board must respond to the out-of-hours review and related concerns, which it commissioned
• Reconnecting with the public and regaining the public’s confidence – the board must undertake and oversee a listening exercise to establish a different approach to public engagement. It needs to do that rapidly and it needs to listen to what it is told by its local population rather than just informing them of the board’s point of view.

The board will be assisted by a set of key individuals who will provide expert advice as a required part of special measures. They include:

• Dr Chris Jones, chair of Cwm Taf University Health Board, who will provide advice and support in relation to GP and primary care services, including out-of-hours services
• Peter Meredith-Smith, the current interim chair of the Board of Community Health Councils and associate director of the Royal College of Nursing in Wales, who will provide expertise in mental health nursing. The mental health 1,000 Lives team will also work alongside Mr Meredith-Smith and the health board to ensure there are sustainable improvements in both the culture of care and services
• Ann Lloyd, a former chief executive of NHS Wales, who will provide oversight in relation to governance and accountability.  

Ministerial oversight of the special measures arrangements will be led by Deputy Minister for Health, Vaughan Gething.

Professor Drakeford said yesterday:

“Yesterday, I took the decision that Betsi Cadwaladr University Health Board should be placed in special measures. I did so following advice from my officials, the Wales Audit Office and Healthcare Inspectorate Wales that the board had not made sufficient progress in addressing long-standing concerns about governance, leadership and progress.

“The measures I have announced today will provide immediate stability and ensure the board has clear and authoritative advice and guidance in discharging its responsibilities. This has all been done – as it should be – by following the processes we have set out in Wales through which these important matters are to be resolved.

“Special measures are only instituted in response to serious concerns – it is not a routine response; it reflects the seriousness of the situation and the conclusion of the tripartite meeting that the health board has not established confidence or assurance in its response to and handling of a range of areas.”

The Minister added yesterday:

“Given the seriousness and exceptional nature of the special measures, these arrangements will be monitored closely and reviewed at an early stage to ensure progress is being made. A formal review of progress, involving Welsh Government officials, HIW and the Wales Audit Office will take place in four months’ time.

“These are challenging times for the health service in North Wales but we must not lose sight of the fact that, every day, more than half a million people receive high-quality care. These measures will strengthen the administration of health services in North Wales for the future.”