Auditor General highlights ongoing challenges at north Wales health board despite leadership improvements

The Auditor General for Wales released a report today detailing the progress made by Betsi Cadwaladr University Health Board a year after it was put into special measures.

In February 2023, the Auditor General published a report in the public interest that described a worrying level of dysfunctionality within the board at Betsi.

The report highlighted a need for immediate action to address fractured working relationships between the health board’s senior leaders that were fundamentally compromising the board’s ability to tackle the substantial challenges the organisation faces.

Following significant changes to the board membership over the last 12 months, and a period of upheaval and churn, the follow-up report published today describes a board that is now more stable.

The report, while acknowledging improvements, also highlighted persistent challenges facing Wales’ largest health board.

The appointment of a new substantive Chief Executive has been highlighted as a positive step forward.

The report indicates that the dysfunctionality previously observed within the board is no longer evident, and there’s a noted improvement in working relationships among senior leaders.

However, despite these advancements, the health board continues to grapple with fundamental challenges, especially as it remains under special measures.

One critical aspect highlighted is the urgent need to finalise substantive appointments to the board to ensure its full capacity.

Additionally, efforts are ongoing to strengthen the Executive Team and address ongoing personnel issues within the Finance Department.

However, further action in a number of areas is still needed. Work must continue to build a cohesive and high performing executive team and to move as quickly as possible to a position where the board has a full complement of substantive executive directors and independent members.

Governance structures that were stood down in 2023 following the resignation of the previous independent members need to be built back up and the issues that led to the suspension of staff in the finance team need to be resolved, the the Auditor General states.

Crucially,the report highlights the need for the organisation to develop its internal capacity and resilience to sustain improvement without requiring continual external support.

Auditor General, Adrian Crompton said today: “It’s assuring to see that the dysfunction within the health board’s senior leadership that we described last year is no longer present. There is now a need for the board to build upon this progress and provide the unified organisational leadership that is needed to address the significant and on-going challenges facing the health board.”

Responding to Audit Wales’ report on Betsi Cadwaladr University Health Board, Plaid Cymru spokesperson for Health and Social Care, Mabon ap Gwynfor MS said:

“While we welcome the progress that has been made to improve Betsi’s board compared to a year ago, this report shows that Betsi should never have been taken out of special measures in the first place.”

“It was a premature and convenient decision by Labour to show progress in health services across north Wales for electioneering purposes, only to place the health board back into special measures two years later after a series of failings.”

“However, the Labour Government must now work with the health board and provide clear timescales for the outstanding actions to be completed – to appoint a full board of Executive Directors and Independent Members.”

“We need clear evidence that the Government has learnt its lesson and that we can move past the normalisation of dysfunctionality and falling standards that’s taken place at Betsi over the years.

“Labour must commit to avoiding taking the board out of special measures prematurely which would undo the progress that has been made, and to be transparent about how they act upon advice provided by the other parties to the tripartite process.”

“Ultimately, their priority must now be to deliver for the people of north Wales.”