Failings at Betsi Cadwaladr University Health Board must be a lesson to all health boards in Wales, says National Assembly Committee
10 December 2013
The governance failings at Betsi Cadwaladr University Health Board (UHB) must serve as a lesson for all health boards in Wales, according to a National Assembly Committee.
The Public Accounts Committee wants the Welsh Government to strengthen performance and accountability procedures for all chief executives and chairs of NHS organisations and undertake an urgent review to help form a new national training programme for all board members to undertake.
The Committee examined the governance arrangements at Betsi Cadwaladr UHB after a joint report from the Wales Audit Office and Health Inspectorate Wales found there had been a breakdown in the working relationship between senior leaders at the health board.
The joint report, the first of its kind in the UK, also discovered that poor communication between the Board and frontline managers and staff meant that not enough attention had been paid to the high rate of C Difficile infections in Glan Clwyd hospital.
During its inquiry the Committee was told of differing priorities among health board directors led to conflicts occurring, which the now former Chair of Betsi Cadwaladr UHB, Professor Merfyn Jones, could not reconcile.
There was also criticism of the outgoing Chief Executive, Mary Burrows, who admitted during evidence that she had concerns about governance problems but failed to report those concerns to the Welsh Government.
Darren Millar AM, Chair of the Public Accounts Committee, said:
“The incoming leadership team at Betsi Cadwaladr University Health Board has a huge task ahead. It needs to urgently restore public confidence whilst establishing a new, robust and accountable governance system that addresses the gap between the Board and the ward.
“The failings highlighted by our inquiry, along with those in the joint report from the Wales Audit Office and Health Inspectorate Wales, are particularly troubling as they come at a time when the entire health sector in Wales is going through seismic changes in both funding and structure.
“With this in mind we believe that the Welsh Government should take the opportunity to ensure that all of our health boards learn from what happened in North Wales so that similar failings don't occur elsewhere and that patient risks are minimised.”
The Committee makes 20 recommendations in its report including:
The Welsh Government reviews and where necessary strengthens the performance management and appraisal process arrangements for chief executives and chairs of NHS organisations to ensure that they are appropriately robust, clearly understood and implemented;
The Welsh Government undertakes an urgent review of the training available to board members across all Welsh NHS bodies. The outcome of this review should inform the development and delivery of a national training programme for board members, participation in which should be a condition of board membership; and,
The Committee welcomes the action being taken by the North Wales Community Health Council to monitor compliance with infection control procedures in hospitals across North Wales. It recommends that the Welsh Government reviews its processes for validating quality and safety, and other critical data from NHS organisations. It is vital that such data is reported accurately if meaningful action is to be taken.