Health board apologises after emergency department placed under special measures

Nation.Cymru staff

The chief executive of Betsi Cadwaladr University Health Board has apologised to patients after healthcare inspectors raised serious concerns about care at one of north Wales’ busiest emergency departments.

Healthcare Inspectorate Wales (HIW) has designated the Emergency Department at Ysbyty Glan Clwyd in Rhyl as a Service Requiring Significant Improvement following an unannounced inspection in May.

The designation follows concerns about leadership, governance, risk management, patient safety and overcrowding within the department.

In a statement issued in response to the inspection, Betsi Cadwaladr chief executive Carol Shillabeer said the health board fully accepted the findings and acknowledged that standards of care had fallen short.

She said: “The issues relate to leadership and culture, patient safety, overcrowding and the safety and experience of patients waiting for care. We are sorry that, in some areas, the standard of care has not been where it needs to be for our patients.”

The intervention marks a setback for the health board, with the emergency department having previously been subject to the same Service Requiring Significant Improvement designation between May 2022 and August 2024.

HIW said the latest action suggested improvements made during that period had not been sustained.

The inspectorate said the designation reflects concerns about whether management systems and oversight arrangements within the department are robust enough to ensure safe care amid continuing pressures on urgent and emergency services.

Although the full inspection report will not be published until September, HIW said it expects “clear and urgent improvement” supported by stronger oversight and accountability.

Alun Jones, chief executive of Healthcare Inspectorate Wales, said: “We have designated the Emergency Department at Ysbyty Glan Clwyd as a Service Requiring Significant Improvement following concerns about leadership, governance and the management of risk.

“This designation means we expect clear and urgent improvement, supported by stronger oversight and accountability.”

In response, Ms Shillabeer said a strengthened improvement plan was already being implemented.

Measures include reducing overcrowding, strengthening patient safety procedures, improving leadership within the department and ensuring patients receive safe care from the moment they arrive, including while waiting to be seen.

The health board will also consider proposals next week to increase staffing levels in emergency departments across north Wales.

Capacity

Ms Shillabeer said the challenges facing emergency care could not be solved by the health board alone, pointing to wider issues around patient flow and capacity that contribute to long waiting times, delayed ambulance handovers and overcrowding.

“We know this will be concerning for the people we serve and for our staff, who are working under sustained pressure, and we want to reassure them that immediate action is underway,” she said.

HIW said patients requiring urgent or emergency treatment should continue to attend the department while improvements are made.