NORTH WALES: Health board showing signs of progress

In May the current leadership of Betsi Cadwaladr University Health Board outlined how it planned to navigate the authority being placed back into special measures earlier this year after the Welsh Government had serious concerns about its performance, leadership and culture.

This was followed by an overhaul of the board and the appointment of an interim chief executive, Carol Shillabeer, parachuted in from Powys Teaching Health Board.

At the last meeting Ms Shillabeer outlined that improvement work would take place across three 90-day cycles, with the first labelled as a ‘period of stabilsation’.

Coming to the end of that first cycle, Ms Shillabeer and Dr Chris Stockport, executive director of transformation and strategic planning, gave an update to the board on progress made.

This included details of visits Ms Shillabeer has made to the health board’s hospitals.

She said: “The key impression I’ve been gaining from every single visit is the motivation of staff, managers, and leaders to improve services.

“I’m very keen to spend more time with colleagues in mental health services, in community and primary care.

“We have to be careful we’re not just overly focusing on hospital-based care.”

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She added: “I’m certainly seeing some really positive signs moving forward.

“I also got some of the real challenges and it’s important we’re taking those back.

“Some of those challenges around single records, the whole pathway, being able to support people back to their homes, and preventing admissions wherever we can. These are the very real issues staff are dealing with.”

Dr Stockport said: “Generally we’re making some good progress.

“There are some areas where we’re a little further behind than we anticipated but those mostly relate to delays to some of the external reviews reporting. Clearly it’s difficult to move to he next step of an internal review until you actually have the review.

“I’m confident that on most of those areas we will be able to make up that lost time.

“There are a lot of external reviews competing for time in this first 90 days cycle. We have nine external reviews. Most of those have been received at least in draft format for correction into the organisation.

“We’re beginning to see some clear tangible green shoots emerge as a consequence of cycle one.

“Our commitment was to eradicate 156-week waits by the end of cycle one in terms of having an appointment booked and we will have done that.”

Interim chair Dyfed Edwards also gave an update on a recent meeting with Health Minister Eluned Morgan MS.

He said: “I think it’s a fair reflection of the discussions with the Minister that she was encouraged by the progress and obviously was looking for us to continue on the road.”

Interim chief executive Carol Shillabeer (Image: BCUHB)

Contained within Ms Shillabeer’s update was a report on her visit to the Maelor hospital in Wrexham.

In that report she noted that the orthopaedics team has drawn up a plan to improve the clinical effectiveness and efficiency of their service recognising the significant backlog of surgery currently being experienced.

She said: “A significant increase in the numbers of patients being seen and having their operation had been achieved, and significant staff satisfaction and confidence in the improvements was evident.”

Ms Shillabeer also scoped out the trauma service, same day emergency care and emergency department (ED).

In her report, she said: “The related trauma service was able to demonstrate a responsive approach to patients who attend the emergency department and it is clear that the trauma service is both extremely busy and has been modified to meet the needs of patients.

“It will be important to track the progress of orthopaedics across the organisation given this is one of the most significantly challenged specialties in the health board and a key priority area in the annual plan.

“A visit to the surgical SDEC (Same Day Emergency Care) was undertaken and plans were shared for changing the layout of the unit in order to support more surgical patients who attend the ED department.

“It was a positive sign of the wider hospital focusing on unscheduled care including within the specialty of surgery.”

Ms Shillabeer added: “Finally the visit was rounded off at the Emergency Department. It was particularly good to see streaming in place from the moment a person enters the ED department.

“This means that patients presenting with minor injuries or minor illness are directed to services immediately next door to the emergency department, in the Urgent Primary Care Centre and the Urgent Treatment Centre. This has resulted in people being seen sooner and being directed first time to the expertise that best meets their needs.”