Performance Overview 2023/24

The past 12 months have again been very challenging for us. We, like every other Health Board in Wales, have faced increased costs, leading to pressure on our already strained budgets as we strive to do the very best for the people of North Wales.

2023/24 also marks the first full year of being placed into special measures by Welsh Government, adding to the issues we face here. Being placed into special measures is not the only issue we have had to deal with this past year. NHS staff across Wales have been on strike and, while we understand the reasons for their industrial action, it has caused disruption to many planned procedures.

Following a critical Audit Wales report on our governance and financial management in 2023, we’re pleased that the latest report published in 2024 acknowledges the progress that we’ve made, although there is still some work to do.

There have been a number of other complex and difficult issues raised during the year:

• We are still experiencing challenges in recruiting staff in some disciplines, but have recently been successful in recruiting nurses from India for some posts.
• Waiting times are still too long in many cases and we share the frustration of patients who are waiting for treatment.
• Primary care services, including dentistry, are under exceptional pressure and we are taking action to improve these services.
• The Health Board was fined following a Health and Safety Executive prosecution. We have apologised to the family involved and are determined to keep improving the service we provide, especially where we fall short of our ambition to be an excellent service.
• We have also been the subject of a number of Prevention of Future Deaths reports from North Wales coroners. We acknowledge the importance of these reports and take them seriously as behind the statistics are people who have experienced personal loss. Work is ongoing to identify and respond to the key themes and points of learning that the reports contain. We have much to improve on to ensure that we provide services with quality and patient safety at their heart.

We have demonstrated areas of improvement during the year, with activity levels across nearly every aspect of our services building on improvements from last year and continuing to increase, and we have successfully delivered a number of key strategic projects.

Our Integrated Health Communities are establishing themselves as a key structure in our efforts to progress our working relationships with local authorities, especially in relation to social services and education.

As for special measures, it is never good for any public body to be placed in this situation. However, it has helped focus our efforts on elements of our service that need improvement.

We have already seen improvements and are treating people sooner in a number of areas. For example, the number of people waiting more than 52 weeks for a first appointment has been reduced by 45% and the number of people waiting over 104 weeks has been reduced by 37%. However, there is much more to be done and we are working hard to address the long waits.

Vascular services have been de-escalated by Health Inspectorate Wales and received a positive external review, and Welsh Government has approved our plans for a multi-million-pound orthopaedic centre in Llandudno that will treat an additional 1,900 patients a year when it’s operational in 2025.

Behind the scenes we’re managing our budgets better. We’ve agreed a financial plan and savings target, and provided additional training for more than 400 staff on improving our procurement practices. We’ve reduced expensive short-term contracts, including interim staff, by 82%.

We now have a full complement of Independent Board Members who can ensure scrutiny of our services through our sub committees.

We’re investing in our staff and are encouraging a positive working culture that is open and transparent so that everyone can share their thoughts and ideas to improve the patient experience. We have made progress over the last year. But we are in no doubt that we still have some way to go. Improving our services so that we exit special measures is important, but even more important is ensuring that all the services we provide are the best for the people of North Wales.

Annual Report 2023/24 - Betsi Cadwaladr University Health Board (nhs.wales)