BCUHB records worst ever cancer and A&E performance as special measures enter fourth year
Betsi Cadwaladr University Health Board has recorded its worst ever performance against cancer waiting time targets and its worst ever performance against the four-hour emergency department target, as it enters the fourth year of special measures with a forecast deficit of £17.4 million.
The Welsh Government published the third annual special measures progress report today, Thursday 5 March, three years and six days after the health board was escalated to level 5, the highest level of Welsh Government intervention, on 27 February 2023.
Cabinet Secretary for Health and Social Care Jeremy Miles MS said in a written statement published alongside the report that too many people in north Wales are waiting too long for care, including cancer services, and that the health board must deliver rapid and sustained improvement.
The report’s findings on cancer are the starkest in three years of reporting.
Performance against the suspected cancer pathway target, which measures whether patients referred with suspected cancer are treated within 62 days, stood at 51.2% in December 2025.
That is the lowest figure ever recorded against this target by the health board.
The standard requires 95% of patients to be treated within 62 days.
The health board is treating just over half.
The report says performance has varied across tumour sites and has fallen throughout the year.
Emergency care figures are equally severe.
In January 2026, BCUHB recorded its lowest ever performance against the four-hour emergency department waiting time target.
The health board also continues to report the highest number of 12-hour emergency department breaches in Wales.
The report says ambulance patient handover delays and flow constraints are contributing to the problems, and that structural pathway change is required for sustained improvement.
The financial position has deteriorated.
The health board met its control total, the agreed financial target set by the Welsh Government, in 2024 to 2025.
For 2025 to 2026 it is forecasting a year-end deficit of £17.4 million.
The report says delivery of savings plans remains challenging, particularly in securing recurrent savings, and that more transformative service and workforce change is required.
The health board’s three-year integrated plan for 2025 to 2028, submitted to the Welsh Government, was described in the report as neither supportable nor approvable.
A separate data reporting failure came to light in November 2025 when the Chief Statistician for Wales temporarily suspended publication of referral to treatment waiting list statistics for the health board following concerns about the accuracy of data submitted over several months.
A review found that a clinician identifier had been omitted from the health board’s monthly reporting, leading to under-reporting in official statistics between April and September 2025.
Reporting resumed in January 2026 after the issue was corrected.
The report does acknowledge areas of improvement since February 2023.
The number of pathways waiting more than two years for treatment has reduced by 66% overall, with an 84% reduction in orthopaedic waits and a 65% reduction for ear, nose and throat treatment.
Since September 2025, more than 45,000 additional weekend appointments have been offered, with 36,578 more people seen.
The number of pathways waiting more than two years for a first outpatient appointment has fallen by 95% compared to December 2024.
More than £6.5 million in new NHS dental contracts have been secured, including the opening of a new dental practice in Connah’s Quay at the end of February 2026.
Child and adolescent mental health assessments completed within 28 days improved from 57.8% in February 2023 to 90% in December 2025.
The health board’s annual accounts have received unqualified audit opinions from Audit Wales for two consecutive years.
The report notes that nine of the 12 executive director and director roles on the board have been filled since February 2023, and that governance and leadership structures have been strengthened.
However, the report says workforce morale is mixed, digital transformation remains an area of significant risk, and cultural improvement will take time.
A major change programme called Foundations for the Future, planned for 2026 to 2027, is intended to align structures, staffing, systems and strategy across the organisation.
BCUHB serves around 697,000 people across north Wales and employs approximately 21,600 staff.
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