Report on health board ‘extremely worrying’
ANEW report has raised major concerns over “dysfunctionality” at a Welsh health board. The report by Audit Wales said Betsi Cadwaladr University Health Board (BCUHB) faced “dysfunctionality and factions” which were majorly impacting its ability to face its “significant challenges”.
The spending watchdog, which published its report yesterday, said the health board – which covers the north of the country and is the biggest health board in Wales – found “fractured working relationships” within the health board’s executive team were preventing it from working effectively.
It said the health board was facing “unprecedented challenges” from demands on its services and longterm concerns over the performance, quality and safety of services.
It said a lack of confidence in the health board’s management, which includes four different chief executives since 2019, had led some individuals to challenge team members in a way that was “perceived by some to be hostile and inappropriate”.
It added that this had “adversely affected working relationships and functionality within the wider board” and led to an inability to resolve issues including soaring demand.
Auditor General Adrian Crompton said the results of the report were “extremely worrying”, adding: “It is clear that there are some deepseated problems with working relationships within the board.
“These problems need to be resolved as a matter of urgency to provide confidence to the public and wider stakeholders that the health board has the leadership it needs to effectively tackle the significant challenges it faces, and to provide safe and effective care to the people of north Wales.”
BCUHB came out of special measures in November 2020 and is currently subject to targeted intervention as part of the Welsh Government’s escalation and intervention framework to deal with issues within its health system.
The Welsh Government has made £82m of additional funding available to the health board per year over three and half years in a bid to improve its services.
Mark Polin, chair of BCUHB, said: “As chair of the health board I welcome the report and the observations and recommendations set out by Audit Wales. I can confirm the board’s commitment to taking the recommendations forward, and we will work collaboratively with Welsh Government and Audit Wales in doing so.
“The health board has been aware of the majority of the issues raised in the Audit Wales report, which partly informed a decision to commission a bespoke board development programme with the Kings Fund to address board effectiveness and relationships in 2020.
“It is most disappointing that previous internal interventions have not resulted in necessary improvements in relation to an effective board, which is what the patients and population of north Wales deserve in order to deliver and receive safe and effective services.
“The board will receive the report and a proposed action plan, to be developed in consultation with the
Welsh Government and other key stakeholders, at the March board meeting, but the required responses will commence immediately.
“In this regard a number of actions are already in train to address some of the serious matters identified in the report, with progress having been made in relation to key areas such as the chief executive officer recruitment, which is under way with our chosen recruitment partner.”
Plaid Cymru’s spokesperson for health and social care, Rhun ap Iorwerth, said: “This is a very critical report which raises further fundamental questions about BCUHB.
“Questions about the board’s structures and leadership have damaged this health board for so many years with most of its time in existence having been in some level of special measures. Again, I stress that I conclude that I don’t believe BCUHB in its current form can serve the people of north Wales effectively. We need a fresh start.”
Welsh Conservative Shadow Minister for north Wales, Darren Millar MS said: “It’s no wonder that the
NHS in north Wales is in such turmoil and that the failings in the BCUHB have gone on for so long.
“The NHS in north Wales needs an executive team that is focused on delivering improvements in patient care and preventing people coming to harm, not one that is rowing with itself or afraid of scrutiny.
“The Welsh Government must urgently intervene to ensure a total clear out of this dysfunctional executive team, without the eyewatering payoffs we’ve seen in the past, and support the chair of the health board to appoint a new and capable team as soon as possible.”
Welsh Liberal Democrat leader Jane Dodds said: “Betsi Cadwaladr has spent years in special measures and this latest report only goes to show that it was prematurely taken out of them. The patients, communities and NHS staff in north Wales deserve better and have continuously been let down by the health board and by the Welsh Government’s failure to act sufficiently on the situation. It is abundantly clear that the health board now needs a completely fresh start.”