Betsi Cadwaladr University Health Board is making progress, but ongoing issues remain, says public sector watchdog.

Betsi Cadwaladr University Health Board (BCUHB), the largest health board in Wales, is still grappling with “fundamental challenges” a year after it was placed into special measures. The move came after serious concerns about its performance, leadership, and culture, as well as financial irregularities. In February of last year, the Welsh government removed the entire board and placed the health board under special measures. Staff members from the finance team were also suspended following the discovery of significant accounting errors.

While the public sector watchdog in Wales, led by Auditor General Adrian Crompton, has acknowledged improvements within the organisation since a “dysfunctional year,” he emphasised that further actions are required. Crompton stressed that vacancies on the board need to be filled promptly and that ongoing issues within the finance department must be addressed. Investigations into the suspended finance staff are still ongoing, with previous reports indicating that the finance team had deliberately misreported spending, incorrectly allocating expenses to a single financial year rather than spreading them across multiple years.

Crompton noted, “It’s reassuring to see that the dysfunction within the health board’s senior leadership that we described last year is no longer present. However, the board must continue to build on this progress to provide the strong organisational leadership necessary to tackle the significant and ongoing challenges.”

The chairman of BCUHB, Dyfed Edwards, welcomed the report, recognising the progress made in the past year but acknowledging there is still much work to be done. “We have created stability and a positive, supportive culture, with a focus on improving service quality and connecting with the people we serve,” he said. He also highlighted the importance of the new leadership, with a new chief executive and board members now in place, providing a “firm foundation” for future improvements.

This is the second time the health board has been placed under special measures, following a similar period of increased scrutiny between 2015 and 2020. Last October, Welsh Secretary David TC Davies called for an independent inquiry into BCUHB, but the Welsh government rejected the suggestion, arguing that it would divert attention and resources from the ongoing efforts to improve healthcare services in North Wales.