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Health Board progress 2024-25

4 March 2025

Special Measures progress 

This time last year, we as a Health Board set out a plan to improve performance across a number of areas that were placed in to the highest level of escalation – Special Measures by the Welsh Government. This plan aimed to address issues around governance and leadership and provide a solid foundation from which the Health Board could then focus its efforts on effectively improving its performance.  

A lot has changed and good progress made over the last two years with the establishment of a new Board, governance structure, change portfolio, operating model, culture and strategy. 

The initial challenge was the appointment and induction of a new Board, led by a new Chair and Chief Executive who have now been in substantive posts since early in 2024. This determined the initial focus and priorities. This was supported by successful recruitment of a full complement of Independent Members and improvement was reflected in the latest Audit Wales evaluation of Board effectiveness. Since then, we have worked hard on the priorities set by Welsh Government, making progress against the associated de-escalation criteria with support from the Welsh Government. 

In 2024/25 the Special Measures actions were incorporated into the Health Board’s Annual Delivery Plan in order to have a single plan for the organisation that encompassed all of its priorities. This evolution saw the maturing nature of the Board take shape with a well-functioning Board turning into longer-term ambitions to build an effective organisation. 

During this time improvements have been made across a number of areas including the way the Board is led, financial management, governance and quality of care processes. 

Whilst a lot of progress has been made in building the necessary foundations for the organisation to be successful in the long-term, much of this work will take time to fully embed and get right. 

We fully recognise that while getting this foundation right is fundamental to driving forward improvement, people are still waiting too long too often to get the care and support they need. It is crucial our communities have access to the quality of service and support they expect and deserve and now this is where we are focusing our attention. 

Along with many other Health Boards, we recognise the challenges to building a sustainable organisation for the long-term whilst also addressing some of the shorter-term performance issues. Whilst this will always be difficult to balance, a lot of the organisational building blocks are now in place to support addressing both in parallel. This is the only way the organisation will successfully deliver on its purpose to improve health and wellbeing and provide excellent care to the people of North Wales. 

We are now working with our partners, as well as listening to and learning from the experiences of our patients and communities, to develop the plans we need to develop and deliver high quality, sustainable services for the future.

Looking ahead to 2025/26, our focus is on building upon the foundational and early delivery work to date and to accelerate delivery of change to front line services, whilst continuing to build a sustainable organisation for the long-term. There are some critical pieces of work that will be fundamental to achieving this, which include: 

  • A concerted effort to improve frontline services, focusing on quality, outcomes and experience. 
  • Working with partners to develop a Ten-Year Strategy for North Wales, that isn’t just focused on health, but the how the whole health and social care system can work together to keep the population well. 
  • Taking the learning from the early implementors using our Quality Management System to support and transform the organisation’s fragile services. 
  • Develop the Electronic Healthcare Record Business Case to support longer term transformation. 
  • Enabling more resource to focus on prevention and early intervention, making better use of opportunities within the primary and community services. 
  • Addressing the long-standing issues with the way the Health Board’s operates, focusing not only on the structure, but also the people, systems, processes, culture and strategy. 

Statement from Dyfed Edwards, Chair and Carol Shillabeer, Chief Executive 

Dyfed Edwards, Chair, said: “I am pleased to see the Welsh Government’s latest progress report reflects the good work that has taken place over the past two years to strengthen the way the Health Board operates.

“Through improved leadership, governance and financial control we have now set a solid foundation to build a sustainable organisation for the long-term, whilst also addressing some of the shorter-term performance issues.

Carol Shillabeer Chief Executive, said: “It is clear that we are making progress and I wish to thank everyone who has been part of the journey so far. It is undeniable that we have much more to do and our focus now is on making further improvements for the communities, patients and staff in North Wales.

“We are committed to developing and delivering high quality, sustainable services for our communities. To do this we will continue to work closely with our partners, the public and harness the innovation and expertise of our workforce.”

Welsh Government announcement

Betsi Cadwaladr University Health Board making progress under special measures | GOV.WALES