Status escalated for Welsh health board which recently had maternity special measures ended

A Welsh health board, which recently had its maternity services taken out of special measures after three-and-a-half years, has had its status escalated in other areas.

Welsh Government has escalated the level of intervention in Cwm Taf Morgannwg Health Board – which recently had its maternity and neonatal services de-escalated – and confirmed Betsi Cadwaladr will remain at targeted intervention to incorporate Ysbyty Glan Clwyd.

In a statement today, Eluned Morgan MS, Minister for Health and Social Services said: “On 5 October, I published a written statement setting out the escalation levels of health boards across Wales.

“I said the escalation status of Betsi Cadwaladr and Cwm Taf Morgannwg university health boards were being considered separately and I would update members following the tripartite meeting.”

Referring to Betsi Cadwaladr University Health Board, she said: “On 7 June, I confirmed my decision to extend the targeted intervention status of the health board to incorporate Ysbyty Glan Clwyd, focusing on the vascular service and emergency department.  

“It is clear there are still a number of serious challenges the health board needs to overcome. I have accepted the advice that there should be no change to the escalation status of the health board.”

On Cwm Taf Morgannwg University Health Board, she said: “On 7 November, I published the Independent Maternity Services Oversight Panel’s latest report.  In recognition of the progress made by Cwm Taf Morgannwg University Health Board, I announced my decision to de-escalate maternity and neonatal services from special measures to targeted intervention.

“However, following the tripartite meeting, I have accepted a recommendation that there should be further changes to the escalation status of Cwm Taf Morgannwg University Health Board.

• The escalation status for quality governance remains at targeted intervention.
• The escalation status for quality related to performance and long waiting times is raised to targeted intervention.
• The escalation status for planning and finance is raised to enhanced monitoring.

“The health board has made considerable progress in respect of quality governance, but it is in the process of implementing a new operating model.  I need to be assured this new structure is embedded across the health board and is having a positive impact on the effectiveness of the health board’s governance processes before there can be consideration of de-escalation in this area.”  

Audit Wales and Healthcare Inspectorate Wales plan to undertake a joint follow-up review of the health board’s quality governance arrangements early next year, which will inform any future deliberations around escalation status.

“Quality and performance across all areas of planned care, urgent and emergency care is a challenge for all health boards as the NHS recovers from the pandemic,” said the Minister. 

“However, the challenges experienced by Cwm Taf Morgannwg University Health Board were noted as considerable, particularly in urgent and emergency care, planned care recovery, child and adolescent mental health services and cancer – these are having a negative impact on the quality of care and patient experience. 

“I have clearly set out my expectations for the recovery of planned care services and the health board has not made sufficient progress against these targets.

“The health board has been escalated to enhanced monitoring for planning and finance because it has not been able to submit a balanced and approved three-year Integrated Medium Term Plan (IMTP). 

“It has therefore breached its statutory duty and was required to submit an annual plan, which has a considerable forecast recurrent deficit of £26.5m.

‘Foot off pedal’

Welsh Conservative Shadow Health Minister Russell George MS said: “It is a shame that after recent progress on de-escalating maternity services from special measures, it has become apparent that in chasing one result, the minister has taken her foot of the pedal and seen things get worse in other parts of Cwm Taf Morgannwg health board.

“Everyone should be concerned that the government are directly intervening because of quality performance and long waiting times because this has very real consequences for patient safety and staff well-being.

“Sadly, the issues facing the NHS are Wales-wide, with most health boards in some state of intervention, record-long waiting lists, the slowest ever ambulance response times, and Britain’s worst A&E waits.

“What we need more than just action is explanation for why this is the case – otherwise, Labour will never get a grip on the NHS and stop breaking all the wrong records.”