"Significant gaps" in record keeping, incident management, team working, reporting concerns, leadership and morale as well as reports of harassment, bullying and staff feeling unable to speak out has led to the Welsh Government stepping in further at a Welsh health board.
Targeted intervention measures for Betsi Cadwaladr University Health Board will be extended to include emergency and vascular services at Ysbyty Glan Clwyd but the Welsh Government health minister has stopped short of putting the health board back into special measures. Targeted intervention is the second highest level of oversight by the Welsh Government.
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Betsi Cadwaladr was removed from special measures in November 2020 under the former health minister having been in them since 2015 but some departments remained under targeted intervention. There had been repeated and serious issues within the health board. You can read about that here. However, today Eluned Morgan has said "serious and outstanding concerns" relating to the vascular service and the emergency department mean Welsh Government will intervene once more.
She said there were "significant gaps" in record keeping, incident management, team working, reporting concerns, leadership and morale and "a series of concerns raised about workforce well-being, cases of harassment, bullying and staff feeling unable to speak out".
Mrs Morgan said: "This decision reflects serious and outstanding concerns about the leadership, governance and progress in Ysbyty Glan Clwyd, including the vascular service and the emergency department."
She said the measures being taken are:
- Support cultural change and promote leadership at Ysbyty Glan Clwyd
- continue to monitor centralised vascular services
- Deploy national clinical leads to the Emergency Department at Ysbyty Glan Clwyd to address the concerns identified by Healthcare Inspectorate Wales.
- Aommission an independent assessment of the progress that has been made against recent mental health reviews
- The Health Minister has also asked the health board to review current governance, audit and effectiveness capacity and work with Improvement Cymru to invest in a rapid education and support programme for improvement skills
- A new Director of Safety and Improvement . Thiwill be appointed
She said the next review will be no later than the end of October 2022.
There were angry responses in the Senedd chamber from North Wales MSs to the news.
Darren Millar, who represents Clwyd West told Mrs Morgan: "You say that this is targeted intervention, but nothing could be further from the truth. It's a scatter-gun approach that you are now taking in north Wales. We have targeted intervention already for mental health services, for strategy, planning and performance, for leadership, including governance, transformation and culture, and for engagement because of the poor engagement with patients, public, staff and stakeholders. Yet, today, you've announced even more targeted intervention, this time at Ysbyty Glan Clwyd in respect of its leadership, which is already in targeted intervention, we are told, its mental health services, which are already in targeted intervention, or so we're told, and, of course, its vascular services now and emergency department, and I have to say, long overdue in terms of intervention required for those".
He said this week marked seven years of the mental health service being in special measures or target intervention.
"We know targeted intervention doesn't work because it's not worked in seven years."
"If you've got a leadership of the health board that is absolutely incapable of making improvements, why aren't you moving that leadership on? Why are you saying that we now need to appoint another executive director at huge cost to the taxpayer. This time for safety and improvement? Why can't the extremely highly paid executive team already in place at the health board delivering the improvements that they are employed to do that is their job and if they're not up to it, they can ship out and go somewhere else because we don't want them in north Wales."
Mr Millar said that it wasn't unique to Glan Clwyd Hospital and there were similar, if not worse issues at Wrexham Maelor Hospital and Ysbyty Gwynedd. "It doesn't make any sense whatsoever".
Plaid Cymru's Rhun ap Iorwerth said this was another example of how "little understanding and appreciation of the gravity of the situation at Betsi Cadwaladr".
He said rather than a "real rolling up of sleeves" there was an extension of targeted intervention. Mr ap Iorwerth said staff knew there had been too much of a delay in introducing these latest measures and that they were "inadequate". "We still don't have a vision about how a sustainable Betsi would work".
Mrs Morgan said: "I wish to reassure both patients and communities served by the health board and staff working for it that day to day services will not be negatively impacted. However, there are significant areas of concern to be considered by the board."
On Wednesday, June 8, there will be a Senedd debate on Betsi Cadwaladr, put forward by the Welsh Conservatives. Mrs Morgan denied the statement made the day before was to dilute the impact of that.
