Welsh Government
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New arrangements for dealing with serious concerns about NHS services and organisations

A clear set of arrangements for identifying and responding quickly to serious concerns about NHS organisations in Wales are being published.

The new arrangements clarify and codify the roles and responsibilities of the Welsh Government, Healthcare Inspectorate Wales and the Auditor General Wales, and how they ensure potentially serious issues are identified as early as possible and addressed effectively.

They also clearly set out the mechanisms for the routine, regular sharing of information, the trigger points which will lead to various levels of intervention, what intervention action should be taken, by whom and when.

Three levels of intervention are being introduced – enhanced monitoring, targeted intervention and special measures for the most serious issues. These levels of escalation will apply to individual services or health boards when evidence shows sufficient and timely improvement is not being made.

The need for a strengthened inspection and regulatory regime emerged from the joint HIW and Wales Audit Office report into governance arrangements at Betsi Cadwaladr University Health Board in June 2013.

Concerns about service delivery, quality, safety, governance or organisational effectiveness, may be raised through routine monitoring and information sharing or by an NHS organisation themselves.

Health Minister Mark Drakeford said:

“First and foremost, I expect all healthcare bodies to have sound and transparent internal assurance processes in place continuously to monitor and improve the quality and safety of services provided.

“That said, our inspection and regulatory regimes need to evolve and keep pace with change so we are assured of a reliable and robust quality assurance system.

“I am confident that, where issues do emerge which give rise to concern, we now have a clear set of arrangements for all to understand how such matters will be systematically dealt with, to ensure proportionate and timely action.

“Wales already has one of the most closely inspected healthcare systems in the UK - this new arrangement will ensure clarity about who is responsible for driving improvement.”

The new arrangements will be in place from April 1 2014.

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