All seven major health boards in Wales are currently in some form of targeted intervention. Some, like the Betsi Cadwaladr University Health Board, have been in special measures for years.
We need to move beyond the cycle of perpetual crisis management in our NHS – a cycle that reflects a system that is too complicated, with a lack of joined-up thinking, too many conflicting priorities and unclear lines of accountability.
To ensure that governance of NHS Wales is fit for purpose, we will:
- Simplify healthcare planning and reporting processes – with clearer priorities and fewer, more focussed and realistic targets.
- Redefine the responsibilities of the Welsh Government and a revamped NHS Executive – with the former responsible for setting the overarching policy direction, and the latter overseeing day-to-day operational matters.
- Develop professional standards for NHS managers and consult on the introduction of a regulatory body, to ensure leadership has the specialist skills and expertise the NHS needs.
- Improve how data about the performance of the NHS is both collected and shared.
- Make it clearer when and why health boards should be taken in or out of special measures, and depoliticise this process by placing it in the hands of the NHS Executive.
- Embed a new, more performance-oriented culture throughout NHS Wales that welcomes both challenge and complaint, and where the patients’ voice is really valued.
- Ensure that examples of best practice are identified, shared and implemented Wales-wide.
Together, these reforms will enable faster and more effective decision-making, against a more rational set of goals and targets, and with a clearer delineation of who is responsible for what. This will provide a new foundation from which to deliver the improved, more robust and sustainable healthcare services that people in Wales both need and deserve.
Demanding more from existing governance structures, we will continue to review whether these structures are fit for purpose, and bring forward plans to change them where needed.
In particular, we will develop a tailored plan to deal with ongoing mismanagement at Betsi Cadwaladr University Health Board, examining all options for reform to deliver better health and care services in North Wales as a matter of urgency.