Introduction and overview from the Chair and Chief Executive

This has been the first full year since we were placed into special measures by Welsh Government, which triggered a change of leadership, including the appointment of a full new team of Independent Members to the Board.

Although the effects of COVID-19 are finally on the wane, we have been dealing with other challenging issues including industrial action by some of our staff and a continuing difficult financial situation. Meanwhile, significant failings with some aspects of our performance have been identified which we are working hard to address.

The financial context in which we, and virtually all other public bodies, operate continues to be challenging, both in the short and long term. Although we have made progress over the last year, we continue to have an underlying financial deficit which we must address.

We also continue to face staff shortages in many key areas, caused by a difficult recruitment market. That is why we, along with other Health Boards, supported the Welsh Government’s recruitment drive for medical staff from India to come and work with us in Wales.

Our main focus throughout the year has been on patients and their needs. We understand the difficulties that many of them experience, including waits at Emergency Departments, for surgery and for dental appointments.

We share their frustrations and know that we can, and must, do better. We have taken a conscious decision to be as open and transparent as possible with the people of North Wales, so that they can understand the pressures we face and we can listen to their views.

That is why we have started a series of community conversations, visiting towns and villages across North Wales, where everyone is welcome to meet and question our Board members and Executive Team on the services we provide. We want to hear about their experiences, both good and bad, so that we can listen and learn. These events will continue throughout this year and beyond. While it is easy to focus on the negatives, there are reasons to be optimistic and for that we must thank our staff. They provide high quality care, support and treatment to thousands of people across North Wales every week, and we wish to pay tribute to their ongoing dedication and expertise for the way they look after our patients and the wider community.

The resilience, commitment and enthusiasm of front-line and support staff is something that we can all be proud of, and that’s why we are optimistic for the future. For example, over the last year we have reduced the number of people waiting 52 weeks for a first appointment by 45%, vascular services have received a positive external review from Health Improvement Wales and received a positive external review, and we have introduced new ways of treating and diagnosing some cancers including using artificial intelligence in breast and prostate cancers.

Construction work on a brand-new orthopaedic hub at Llandudno Hospital has also started. The Welsh Government agreed funding of up to £29.4m for the new facility to help reduce orthopaedic waiting times. The new hub will transform elective orthopaedic services by delivering a planned 1,900 procedures a year and will be operational in 2025.

We do recognise that we can’t operate in isolation because we are part of a much wider health and social care system that includes local authorities, educational institutions, voluntary organisations and the ambulance service.

We value the partnerships we have with these and many other organisations across North Wales and beyond. They face similar challenges to us to meet growing demands within their available resources, and we will continue to work closely in partnership with them wherever possible to maximise the resources available to improve the health and wellbeing of our population.

For example, we continue to work closely with Bangor University where the first full medical degree programme in North Wales, delivered in collaboration with Cardiff University and primary care providers in the region, will welcome its first students in September 2024.

There is no doubt that the coming year will continue to be challenging, but there is hope for the future. We have produced a three-year plan, setting out our ambitions through to 2027, that embraces a culture of improvements to our services that we believe shows that we are prioritising the right things to improve the health service in North Wales.