Posted: Thu 10th Mar 2022

North Wales health board ‘too large’ to run effectively, says Senedd Member

News and Info from Deeside, Flintshire, North Wales
This article is old - Published: Thursday, Mar 10th, 2022

Questions have been raised over whether the health board responsible for running NHS services in North Wales is “too large”. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

It follows vascular services at Betsi Cadwaladr University Health Board being designated as “requiring significant improvement” by Health Inspectorate Wales (HIW). ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Health officials in the region have come under fire in recent months after a “damning” report by the Royal College of Surgeons, which raised serious questions about the quality and consistency of vascular care. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

It led to Health Minister Eluned Morgan issuing a “clear warning” for vascular services to be improved within the next three months or the board could face “further escalation measures”. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Following news of the HIW measures, Ynys Môn MS Rhun ap Iorwerth has raised doubts over whether the health board is sustainable in its current structural form. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

During a Senedd session held yesterday, the Plaid Cymru MS said: “The announcement and the statement by Healthcare Inspectorate Wales is sobering. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“HIW has put this escalation measure in place because the Royal College of Surgeons report identified a number of concerns that we believe indicate a clear risk to patients using the vascular service. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Now, vascular patients have been put at risk because of poor management, just as mental health patients’ lives have been put at risk through a number of scandals within the same health board. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“I repeat my call today: put vascular services in Betsi Cadwaladr University Health Board in the highest possible level of special measures you have, and do so with the patient in mind. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“I don’t want reorganisation any more than the minister does, but this again smacks of a health board that is too large, too unwieldy to be run effectively, and too distant from the people it serves. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Episode after episode, such as the one we’re discussing today, mean that the redesigning of health services across the north has to be left on the table.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The service of concern process for the NHS was introduced in November 2021. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

It is used when significant service failures are identified, or when there is an accumulation of concerns about a service or setting. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The intention of the process is to support improvement and learning, both for the service in question, and across NHS services more broadly. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Further explaining the status on its website, HIW said: “The service requiring significant improvement designation enables us to plan and deliver future activities necessary to gain assurance about the quality and safety of care in that service. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“We will be working with the health board to ensure improvements are made in a timely manner. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“We will then consider whether the service can be de-escalated and removed from this process.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Responding to Mr ap Iorwerth’s comments, the Health Minister did not specifically say whether she would support a re-organisation of the health board. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

However, Eluned Morgan stressed that she understood vascular services in the region were not good enough. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

She said: “I’ve said, and I’ll say it again, that the vascular services and the services offered in Betsi are not at an acceptable standard. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“I did issue a written statement on February 3 following that report by the Royal College of Surgeons, and it was very disappointing to find that there were some really fundamental and basic things that were not being done. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Deficiencies in care, record keeping, consent taking, following up, all of these things that you would assume are basic things that happen in every department within the care service. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“I have made it clear that they’ve got three months to address these issues, and that has started already, and it’s very clear to me that I will be receiving monthly updates from the health board. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“If significant progress has not been made in those three months, I will require escalation measures or oversight, and we will convene a special tripartite meeting to consider that.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​


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