Cardiff and Vale, ABMU and Hywel Dda are just one level short of ‘special measures’
Three Welsh health boards have been placed under the second highest level of monitoring by the Welsh Government for failing to address the serious challenges they face.
Cardiff and Vale, Hywel Dda and Abertawe Bro Morgannwg (ABMU) University Health Boards were escalated to “targeted intervention” on Wednesday – just one level less than the most serious “special measures”.
All three Welsh health boards were criticised for failing to deliver suitable three-year business plans which address issues such as care quality, workforce and finances.
ABMU was described as facing “continuing challenges” in areas such as unscheduled care, which includes A&E departments, and cancer.
Despite improvements in some key areas, Cardiff and Vale did not give the Welsh Government the “necessary confidence” that the organisation has a deliverable and affordable plan for the next three years.
And Hywel Dda UHB was described as facing a number of “long-standing challenges” and has not yet been able to produce a plan to address them.
In a joint statement, chairman of ABMU Professor Andrew Davies and its chief operating Officer Alex Howells said: “As a health board we are committed to continuous improvement in all our services and are determined to deliver the best possible care for our patients.
“We have made significant progress and seen improvements in many areas but recognise that we are currently facing a number of specific challenges about how to best deliver sustainable services that meet the increasing needs of our population.
“We fully accept the need for targeted improvement in a number of important areas, not least in unscheduled care.”
‘Unique challenges in Hywel Dda’
Hywel Dda University Health Board said it welcomed additional support and targeted intervention from the Welsh Government.
Chief executive Steve Moore said: “We have unique challenges in Hywel Dda, providing healthcare to a large geographical area, mainly rural but with urban pockets and with significant workforce challenges.
“We’ve been working very hard to make improvements, not just by ensuring prudent use of our finances, but also in improving our workforce position.”
Hywel Dda said it has already been taking action to improve its financial position.
Mr Moore added: “Progress has already been made during the last year to better understand the scale of the issue and to stabilise our position as much as possible. We have more grip than ever before.”
‘We cannot solve this alone’
He also wanted to recognise and reassure health board staff.
“Our staff continue to rise to the challenge, consistently providing patient centred care and working with us on improvements and innovation and we are hugely grateful to them,” he said.
“We accept that we while we have long-standing financial challenges and whilst we cannot solve this alone.
“We are confident that with additional support, we have an opportunity to provide the organisation and the patients we serve with the assurance that we have a sustainable plan and financial position for the future.”
Chief Executive Officer, Cardiff and Vale University Health Board Professor Adam Cairns said: “We understand why the decision has been taken and welcome the opportunity to agree with Welsh Government the details of the targeted intervention. We believe that this will further support delivery of our agreed 10 year strategy.
"As a University Health Board we acknowledge the significant challenges we face but we will continue to focus on our delivery plan, work positively to improve performance and continue to provide excellent treatment and care for the patients and communities of Cardiff and Vale and those across Wales.”
The three organisations will now be monitored against a one-year improvement plan.
The Welsh Government, Wales Audit Office and Healthcare Inspectorate Wales meet twice a year to consider escalation and intervention arrangements for NHS organisations.
The four escalation levels
- Routine arrangements
- Enhanced monitoring
- Targeted intervention
- Special measures
Betsi Cadwaladr University Health Board is the only NHS organisation placed under “special measures” following concerns over its management and mental health services.
As part of their last meeting, the Welsh Ambulance Services Trust was de-escalated from “enhanced monitoring” to “routine arrangements” following the considerable progress the trust has made.
The escalation level for each health board
- ABMU – Targeted intervention (previously enhanced monitoring)
- Aneurin Bevan – Routine arrangements
- Cardiff and Vale – Targeted intervention (previously enhanced monitoring)
- Cwm Taf – Routine Arrangements
- Hywel Dda – Targeted intervention (previously enhanced monitoring)
- Powys Teaching – Routine arrangements
- Public Health Wales – Routine arrangements
- Velindre – Routine arrangements
- Welsh Ambulance Service NHS Trust – Routine Arrangements (previously enhanced monitoring)