Decade of improvements may still be required for troubled Betsi Health Board

A decade of improvements may still be required at the troubled Betsi Cadwaladr health board, which has been in and out of special measures since 2015, a committee heard.

MSs on the Senedd health committee grilled newly appointed bosses at the health board.

Dyfed Edwards, interim chair, warned that up to a decade of improvements could be required to meet intervention measures, saying: “This is probably a five- to 10-year task.

“If it means being in special measures for five to 10 years, I don’t have a problem with that….

“It’s not an aim for us as a board to say ‘right on March 17 at 2pm, we’re going to get out of special measures’ – that’s not a consideration.”

Asked if she has the most difficult job in Wales, Carol Shillabeer, who was appointed chief executive this month after serving on an interim basis, said she is delighted to be staying.

Mr Edwards said he followed the trials and tribulations of the health board over the years and his first impression was mixed when he arrived in February.

He said the organisation, which has 19,000 staff, was seeking direction more than anything as well as a culture of kindness.

Special measures

Russell George, who chairs the committee, called for an update on special measures which were escalated at the end of February.

Ms Shillabeer said the health board is currently in the stabilisation phase and will be moving onto standardisation from April.

She told committee members: “Clearly, the organisation has been in and out of special measures for a decade or so.

“It’s going to be really important that we make long-lasting, sustainable change.

“This change has got to be not just one that delivers an improvement that is sufficient to get out of special measures – that’s not our first and foremost priority.”

Ms Shillabeer stressed that improvement is not always in a straight line, saying there are days and weeks when the health board takes one step forward and two steps back.

Pressed by Mr George on missed goals, she said the health board is yet to receive reports on mental health reviews, planning and the clinical governance system.

Finances

Responding to a question from Labour’s Sarah Murphy, Ms Shillabeer told MSs that the health board – which is the biggest in Wales – is facing acute financial problems.

She said: “We are currently spending just over £2bn which is a huge amount of public resources. How we spend that is going to be really, really important.”

Ms Shillabeer – who is Betsi’s 10th chief executive in as many years – said the health board is balancing quality, long-term plans and breaking even

She told the committee: “We know the rest of the public sector are really challenged as well so the NHS has to take its responsibility seriously.”

Mr Edwards stressed the importance of financial discipline while cautioning that it does not come easy due to pressure on services.

On independent reviews into patient safety, interim staff and procurement, Ms Shillabeer highlighted data, culture, engagement and governance as common themes.

‘Reset’

Gareth Davies, the Conservative MS for Vale of Clwyd, who previously worked for the health board, pressed the health chiefs about special measures.

Mr Edwards said the health board needs a reset, not just a refresh.

“It’s almost like creating a new health board,” said the former Gwynedd council leader.

He said an emphasis will be put on openness and transparency.

Responding to calls for the health board to be split up, Ms Shillabeer told MSs that there is no evidence that there needs to be a reconfiguration.

She said the health board will have a relentless focus on standards.

She told the meeting on Thursday November 23 that she sees special measures as a partnership between the health board and the Welsh Government.

Ms Shillabeer said: “There’s a lot of focus on making changes quickly and I agree with that – we have got a lot of patients waiting a long time for their operations.”

However, she stressed that the health board must also sufficiently focus on the long term.