Welsh Government urged to ‘clear out’ Betsi Cadwaladr leaders as report reveals ‘fractured relationships’ are harming progress

A report by the Auditor General for Wales has highlighted deep-rooted issues with working relationships at the most senior levels of Betsi Cadwaladr University Health Board. ‌​‌‌​​​‌‍‌​‌​‌​​​

The report states that the breakdown in relationships within its executive team is compromising the organisation’s ability to tackle the numerous challenges it faces. ‌​‌‌​​​‌‍‌​‌​‌​​​

The North Wales health board is currently dealing with high demand on its services, while also trying to address long-standing concerns over the quality, performance, and safety of a number of services. ‌​‌‌​​​‌‍‌​‌​‌​​​

The report shows that fractured working relationships within the executive team are preventing the board from working effectively, leading to a lack of confidence from independent members in the team’s ability to tackle the issues. ‌​‌‌​​​‌‍‌​‌​‌​​​

The report also notes that a heavy reliance on interim posts within the senior management structure is still evident, which points to ongoing difficulties in securing the senior leadership that the health board needs. ‌​‌‌​​​‌‍‌​‌​‌​​​

It said the health board had invested in an extended program of board development work to try and address some of the issues. ‌​‌‌​​​‌‍‌​‌​‌​​​

However, this work was partly affected by the need to respond to the pressures of the Covid pandemic and is reported not to have been successful. ‌​‌‌​​​‌‍‌​‌​‌​​​

Adrian Crompton, the Auditor General for Wales, said: “The findings from my review of board effectiveness at Betsi Cadwaladr University Health Board are extremely worrying. ‌​‌‌​​​‌‍‌​‌​‌​

“It is clear that there are some deep-seated 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. ‌​‌‌​​​‌‍‌​‌​‌​​​

“The Welsh Government will need to use the current escalation and intervention framework to support the urgent improvements that are necessary.” ‌​‌‌​​​‌‍‌​‌​‌​​​

The Welsh Conservatives have reacted to the report by calling for the Welsh Government to step in and replace senior leaders within the health board.

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 Betsi Cadwaladr University Health Board 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 eye-watering 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.” ‌​‌‌​​​‌‍‌​‌​‌​​​

Betsi Cadwaladr University Health Board is responsible for the delivery of health services in North Wales and has a budget of over £1.3 billion. ‌​‌‌​​​‌‍‌​‌​‌​​​

The organisation provides a wide range of health services, including hospitals, community services, and mental health services. ‌​‌‌​​​‌‍‌​‌​‌​​​

The health board covers a population of over 700,000 people and is one of the largest employers in the region, with around 16,000 staff. ‌​‌‌​​​‌‍‌​‌​‌​​​

Mark Polin, chair of Betsi Cadwaladr University Health Board, said he welcomed the report and its recommendations.

The former chief constable of North Wales Police said: “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 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 underway with our chosen recruitment partner.”