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Improved access, outcomes and experience

Three Year Plan 2024-2027
Looking to the future, find out more about our Three Year Plan 2024-2027 on this website by clicking here. 

April 2023 - March 2024

We know that people are frustrated about the amount of time they have to wait for appointments. There are too many people experiencing difficulty accessing a GP or an NHS dentist and too many are waiting too long for hospital appointments and important diagnostic tests.  

At the time of being placed in Special Measures, a number of our services were particularly challenged and over the last year considerable effort has gone into improvements in these areas.  

Progress made  

  • We have established a North Wales Dental Academy to address recruitment, retention and to upskill staff within the dental profession. It is providing an additional 8,000 patient places since opening in October 2022. 

  • Our GP Managed Practices have achieved the national access standards this year.  

  • There are three training hubs in Health Board practices (West and Central areas) which were set up through the Primary Care Academy. A fourth is planned in the East area. The benefits of these are: helping to retain GPs with improved role offers, training is supported in rural areas and GPs are able to undertake training in both Welsh and English.  

  • We’ve seen a 62% reduction in people waiting over 156 weeks. They have now either received a date for their first appointment or have started treatment. There are some challenges remaining within Orthodontics but we are working hard to address this.  

  • We have seen a 52% reduction in people waiting 52 weeks for their first outpatient appointment, this is equivalent to 13,000 people.  

  • We’ve seen a 42% reduction in people waiting 104 weeks in comparison with our position last year, which is more than 6,000 people.  

  • We’ve seen significant improvements in planned care. This particularly relates  Orthopaedic services, with new ways of working in Abergele and an approved business case for an orthopaedic hub in Llandudno This means more people will be seen sooner at a dedicated site running for 50 weeks of the year. This will play an important part in reducing our waiting lists.  

  • The number of patients waiting more than eight weeks for a diagnostic test has continued to fall significantly each month with 5,943 people waiting in November 2023 compared to nearly 10,000 in November 2022.  

  • Vascular Services: In June 2023, Healthcare Inspectorate Wales published their report on vascular services following an unannounced inspection the service was de-escalated from 'a service requiring significant improvement'. Considerable work has been undertaken to address the improvement recommendations that were identified in a number of external reviews, including The Royal College of Surgeons and Healthcare Inspectorate Wales. The impact of the improvement work can be evidenced through the service’s performance throughout 2022, against the following key indicators, outlined within the NVR Statement of the Nations Report (November 2023). Outcomes and survival rates have improved for people who have had AAA repair, bypass surgery and amputations, for example. 

  • Mental Health: Whilst the leadership and management of the mental health service (including children and adolescent services) remains challenged, there have been a number of positive Healthcare Inspectorate Wales inspections undertaken over the last 12 months highlighting a stabilising service.  A review of mental health inpatient quality and safety is being carried out to see where improvements have been made and sustained.  

  • Since launching the 111 Press 2 service last year, the health board has taken more than 8,000 calls from people who require urgent mental health support. Feedback has shown 99.3% of callers reported a reduction in their distress scores after contact with dedicated wellbeing practitioners. Referrals to local primary mental health support services have reduced by 8%.  

  • Wrexham Maelor Hospital is the first in Wales to use a new procedure to remove bladder tumours or suspicious areas. The procedure uses a Trans Urethral Laser Ablation (TULA), an examination of the bladder using a camera on a thin flexible tube that uses a laser for bladder treatment.  This will improve people’s outcomes and experience.  

  • The Health Board is the first in the UK to use the artificial intelligence software called the Galen platform clinically to assist in diagnosing breast cancer.    

  • A “straight to test” pilot approach has been implemented for some cancer patients. It means patients have an mpMRI test sooner after being referred for diagnostics on a ‘suspicious of cancer’ pathway, either by being triaged by a Clinical Nurse Specialist or Consultant without first needing to be seen.  This has enabled patients to be seen quicker, undergoing an MRI around 18 days after a GP referral.    

  • The Health Board has completed the expansion of Wrexham Maelor Hospital’s Emergency Department, which has created more consulting and treatment rooms for patients who need urgent care.   

  • The discharge lounge at Glan Clwyd Hospital has been enhanced and now provides a discharge hub to accommodate patients for up to 24 hours, helping manage the flow of patients through the hospital and reducing unnecessary delays for those people who are ready to go home.  

  • Results from a recent National Training Survey by the GMC shows more than 90 per cent of doctors in training are pleased with the quality of clinical supervision, experience and the teaching they receive at Ysbyty Gwynedd Emergency Department, which was also ranked best place to train in the UK by junior doctors in the same survey.  

Future Plans  

  • We are moving forward with our plan to develop an orthopaedic surgical hub and centre of excellence in Llandudno. It will be located away from our larger acute hospital sites so that the staff, beds and service as a whole will not be impacted by emergency demands for care on the hospital site. This way of working is very successful across the UK and the aim is to deliver 1,900 orthopaedic procedures per year in North Wales. 

  • We are continuing to work closely with colleagues across the health and social care system, Welsh Government and the Welsh Ambulance Services NHS Trust to alleviate urgent care pressures and improve the experience of our patients.  

  • Reducing delays across our Emergency Departments: People are still waiting too long to be seen and treated. Performance against the four-hour target has been consistently below the expected level. After remaining consistent around the 69% mark for the previous three months, the percentage of patients experiencing waits of more than four hours in our Emergency Departments dropped to 66.3 per cent in November 2023.  

Betsi Cadwaladr University Health Board, one year on: digital download