Health
Health board still in crisis as Welsh Government says ‘significant challenges remain’
Betsi Cadwaladr remains in special measures two years on — concerns over waiting times and emergency care as pressure continues across Wales
WALES’ biggest health board remains under special measures more than two years after being placed into the highest level of Welsh Government intervention — with ministers admitting that “significant challenges” still exist in planned and emergency care.
Cabinet Secretary for Health and Social Care Jeremy Miles issued the warning in an update to Members of the Senedd on Friday (Oct 24), saying that while there had been “sustained progress in some parts of the organisation”, the board must make urgent improvements to tackle record waiting lists and delays in emergency treatment.
Two years under the spotlight
Betsi Cadwaladr University Health Board, which covers north Wales, was first placed into special measures in 2023 following years of financial mismanagement, governance failings and concerns over patient safety.
Since then, the Welsh Government has published regular progress reports detailing reforms and leadership changes, including new oversight arrangements and a focus on financial control, quality improvement and patient engagement.
The latest, the eighth report since 2023, acknowledges that while planning and governance have improved, long waiting times remain the worst in Wales — with the board responsible for the largest share of people waiting more than a year for treatment.
Impact felt beyond north Wales
Although Betsi Cadwaladr’s area covers north Wales, the ripple effects of its ongoing instability are being felt across the country. The health board accounts for a large proportion of referrals into specialist services, creating knock-on delays for hospitals elsewhere in Wales, including Hywel Dda University Health Board, which serves Pembrokeshire, Carmarthenshire and Ceredigion.
Sources within Hywel Dda have previously warned that national pressures in surgical and diagnostic capacity, particularly in orthopaedics and ophthalmology, are linked to system-wide backlogs in other health boards — including Betsi Cadwaladr.
Mr Miles said: “The health board must focus on making urgent and sustainable improvements to waiting times for planned care and to urgent and emergency care. This must be a priority as it has by far the largest proportion of – and the longest waits – in Wales.”
‘Support and challenge’ promised
The Cabinet Secretary insisted the Welsh Government would continue to provide “support and constructive challenge” to ensure the board delivers safe, sustainable and timely services.
However, opposition parties and patient groups say it is unacceptable that the health board — which serves around 700,000 people — remains in crisis nearly a decade after its first period of special measures in 2015.
A spokesperson for the Welsh Conservatives said: “This shows once again that the Welsh NHS is trapped in a cycle of failure under Labour. Patients in north Wales — and indeed across the country — deserve better than endless reports and excuses.”
Wider Welsh NHS strain
Hywel Dda, which runs Withybush Hospital in Haverfordwest, Glangwili in Carmarthen and Bronglais in Aberystwyth, continues to face similar pressures, with emergency departments operating above safe capacity and thousands waiting over a year for routine procedures.
The situation at Betsi Cadwaladr underscores the strain across the Welsh NHS — and the scale of the challenge facing the new Health Secretary as winter pressures begin to bite.
Health
Wales begins early NHS winter planning after long waits and ambulance pressure
Ministers say health boards and councils must act now to ease pressure on hospitals, ambulances and social care before winter
THE WELSH GOVERNMENT has told NHS Wales and social care partners to start planning earlier for winter, after a difficult year for emergency care and recent heatwave pressure on ambulance services.
Health and Care Minister Mabon ap Gwynfor said the aim was to make ambulance, emergency department and hospital services safer and more resilient during the colder months, while also recognising that pressure on the NHS is no longer confined to winter.
The announcement will be closely watched in west Wales, where Hywel Dda University Health Board runs Withybush, Glangwili, Bronglais and Prince Philip hospitals.
Latest published figures show Hywel Dda performing better than the Wales average on emergency department waits in May, with 66.5% of patients admitted, transferred or discharged within four hours and 9.9% waiting more than 12 hours. However, the health board remains well short of the Welsh Government’s 95% four-hour target, and therapy waiting times in Hywel Dda were worse than the Wales average.
Across Wales, 64.4% of patients attending emergency departments in May spent less than four hours there, while 11,066 patients waited 12 hours or more. Official figures also showed more than 1,300 “pathway of care” delays on the day data was collected, meaning patients were clinically ready to leave hospital but were still waiting for the right care, support or accommodation.
The Welsh Government says this year’s winter plan will focus on five key areas: preventing illness through improved vaccination uptake, keeping more people well at home, freeing up hospital beds through better infection control and earlier discharge, helping patients leave hospital safely when they are ready, and keeping services running under pressure while supporting staff.
An expansion of the RSV vaccine to people aged over 65 who are clinically at risk will begin in September. Ministers also want stronger uptake of vaccination among people at greatest risk, NHS and care staff, and children.
A new communications campaign is also being developed to help people understand where to go for care, so that emergency departments and ambulances are preserved for those with the most serious needs.
Mr ap Gwynfor said: “Our fantastic NHS and social care staff worked incredibly hard last winter, and we are being clear with health boards and partners more needs to be done.
“Last winter was tough. Too many people waited too long for the care they needed, and that’s not good enough. Early planning and action are key, and I’ve also asked officials to begin planning now so we’re better prepared for the winters ahead.
“I am also clear that this is not just a winter challenge. The recent period of extreme heat is a clear reminder that pressures and risk can arise at any time of year.
“Our ambition is simple: safe services all year round that protect ambulance and hospital capacity for those who really need them, ensuring people get the right care, in the right place, at the right time.”
The statement follows renewed concern from emergency medicine doctors about long waits and so-called corridor care. The Royal College of Emergency Medicine has warned that poor patient flow, delayed discharges and a lack of inpatient beds are leaving too many patients stuck in emergency departments for long periods.
The British Medical Association in Wales has also called for clearer recording and reporting of corridor care, arguing that without better data it is harder to understand the scale of the problem and hold decision-makers to account.
There was a further warning last week when the Welsh Ambulance Service declared a critical incident during the extreme heat. The service said 999 call volumes had risen by 31% compared with two weeks earlier, with around 400 additional emergency calls a day. The critical incident was later stood down, but ambulance chiefs said demand remained high.
The political test for the Plaid-led Welsh Government will be whether early planning can translate into visible improvements by winter. Health boards and councils will be expected to work together more closely, but many of the problems ministers are trying to solve depend on social care capacity, staffing, available beds and community services.
For patients and families in Pembrokeshire, Carmarthenshire and Ceredigion, the key question will be whether the plan leads to shorter ambulance waits, fewer long delays in A&E, and quicker support for people well enough to return home from hospital.
Health
Welsh Ambulance Service tightens eligibility checks for patient transport service
THE WELSH AMBULANCE SERVICE has announced changes to the way it assesses eligibility for its Non-Emergency Patient Transport Service (NEPTS), saying the move is needed to cope with increasing demand and ensure support is available for those who need it most.
The service, which provides transport to and from healthcare appointments for patients who are unable to travel independently because of their medical condition or mobility needs, is introducing a more consistent approach to applying Welsh Government eligibility criteria.
In a statement released on Tuesday (July 1), the trust said it was also improving the way patient journeys are planned and managed, with the aim of reducing short-notice cancellations and making the service more reliable for eligible patients.
The announcement comes just days after the Welsh Ambulance Service declared a critical incident following a significant rise in demand across its emergency services, highlighting the wider pressures facing healthcare transport across Wales.
The trust said the eligibility criteria themselves are not changing, but assessments will be carried out more consistently to ensure limited resources are directed towards patients with the greatest need.
A spokesperson said: “We’re strengthening how we assess eligibility for our non-emergency patient transport to help ensure support is available for those who need it most.
“Due to increasing demand, we are applying Welsh Government eligibility criteria more consistently and improving how journeys are planned and managed. Our aim is to reduce short-notice cancellations and provide a more reliable service for eligible patients.”
Patients who currently use the service may notice additional questions or checks when transport is booked or reviewed.
The Non-Emergency Patient Transport Service is separate from the 999 ambulance service and is primarily used by patients attending regular hospital appointments, dialysis, cancer treatment and other healthcare services where independent travel is not possible.
The Welsh Ambulance Service is encouraging anyone concerned about their eligibility or transport arrangements to contact the service for further information.
The changes are expected to be rolled out across Wales over the coming months.
Health
Wales’ only specialist eye hospitals strengthen senior team
WALES’ only specialist eye-care hospital, Sana Private Health, has expanded its senior team to welcome Francesca Oak as a new Business Relationships Manager.
Aiming to increase Sana’s optometry network across Wales, Francesca’s appointment represents the Cataract Centres of Excellence’s approach to enhanced patient care, particularly for those with complex eye health conditions.
The new role has been created as demand for specialist eye care continues to grow across Wales, with increasing numbers of patients seeking treatment for age-related eye conditions including cataracts, glaucoma and macular degeneration.
The appointment will see Francesca, who holds extensive experience in optometry practice, provide expert consultation for optometrists. Advising on bespoke treatment options available for patients, Francesca will also take feedback from optometrists to shape Sana’s future planning based on patient needs.
It is the first time the hospital has brought in a specialist in relationship management, demonstrating Sana’s commitment to improving patient pathways to care. Coupled with the recent investment in renovating its Bridgend hospital, the new role highlights Sana’s continued growth.
Speaking of her appointment, Francesca Oak said: “I’m delighted to join the team at Sana Private Health at this exciting time for the hospital. We are seeing real growth and investment in cutting-edge technologies which will enhance patient care, and I’m looking forward to working with optometrists across Wales to shape our approach to care.”
With hospitals in Swansea and Bridgend, Sana Private Health was established in March 2023 by world-leading ophthalmologists Mr Luke Anderson and Mr Mario Saldanha.
The private healthcare centre offers treatment for glaucoma, retinal disorders, macular degeneration, cornea conditions, refractive lens exchange, laser vision correction, and is a leading specialist centre for cataract removal.
Mr Luke Anderson, Founding Director and Ophthalmic Surgeon at Sana Private Health, said: “Bringing Fran into the team represents our commitment to excellence, strengthening our relationships with optometrists across the country.
“Patients need to feel confident that, when they speak to their optometrists, they’ll be able to access the right treatment in outstanding facilities. By bringing Francesca on-board, we’re improving our outreach to optometry practices and ensuring patients have an efficient, practical and tailored referrals process, so they can be seen by a specialist quicker and get back to the life they love.”
To find out more, visit https://www.sana-health.co.uk/
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