Betsi Cadwaladr University Health Board’s chief executive says the organisation’s key focus moving forward are long-term goals, a year after being placed back in special measures.

But the chief executive also admitted North Wales’ NHS service was ‘nowhere near good enough’ when addressing a board meeting today.

The health board’s board met at Llandudno’s Venue Cymru to discuss several reports, including improvements made over the past year since being put in special measures.

On February 27, 2023, Welsh Government announced that Betsi Cadwaladr was being placed in the highest level of escalation after serious concerns about performance, leadership, and culture.

The health board had only been taken out of special measures two years earlier in 2021.

Consequently, the minister for health and social services highlighted eight areas of concern.

These included governance and board effectiveness, workforce and organisational development, financial governance and management, compassionate leadership and culture, clinical governance, patient experience and safety, operational delivery, planning and service transformation, and mental health.

Board members were then forced to quit and new members appointed.

Speaking at Venue Cymru today, chief executive Carol Shillabeer said the health board was looking at long-term improvements but admitted things were still ‘nowhere near good enough’.

“The organisation was spinning a year ago. There were pretty dramatic changes made, and that has an impact on how an organisation can function,” she said.

“So our key focus has to be to try and get an organisation that can function well because when we've got an organisation that functions well, we are able to tackle the issues that matter to people. So I see this as a continuum. We have to focus on the immediacy, but if we are only on the immediacy, we are never building for the long term. But if I was talking to people in your community, I would be saying we are starting to get a stronger organisation but starting.

“We are starting to make some improvements to care, and there's lots of evidence of great care that goes on every single day, I should say. But we know it’s nowhere near good enough yet. We are working night and day to make the improvements that we need to make, and people will see that improvement coming through.”

She added: “But it's not necessarily going to be overnight, so there is something about expectation management here. It’s about making change for the long term.”

Board members heard how an action plan had been devised and a board development programme developed and implemented focusing on areas of concern, including the eight areas highlighted by Welsh Government. Other improvements included planned care waiting times, including a 19% reduction in people waiting 208 weeks to start treatment; a 63% reduction in people waiting over 156 weeks for their first appointment or to start treatment, and a 21% reduction in people waiting 104 weeks compared to last year.

The board heard how there had been ‘systematic improvements in planned care’ in regards to booking and scheduling. There had also been improvements in vascular care, following the Healthcare Inspectorate Wales deescalating it from a ‘service of concern’.

An initial review of mental health inpatient safety took place in spring 2023 and an action plan implemented as a result. The board also heard how urgent and emergency care work at emergency departments was ongoing. But whilst the report said ‘some improvement had been achieved’ winter pressures had hampered efforts and further improvements were still required.

Despite this the board acknowledged more changes needed to happen across the service. Executive medical director Nick Lyons also commented: “There are huge challenges left for us. But perhaps we should (acknowledge) there has been a 63% reduction in people waiting over 156 weeks.

“Of course, that does mean many people are still waiting huge lengths of time, and our hearts go out to those people, and we are working on a day-by-day basis to do something about that.”

Other improvements included five and six year waiting times eradicated; 18 days improvement in prostate cancer diagnosis; and a £29m investment in Llandudno Hospital.