Written statement (Wales): Escalation and Intervention Arrangements - July 15

Jeremy Miles MS, Cabinet Secretary for Health and Care: I have accepted the recommendations from Welsh Government officials about a change in the escalation status to a number of NHS organisations. I will make an oral statement to the Senedd later today.

The revised escalation status of NHS organisations is as follows: 

Aneurin Bevan University Health Board

Aneurin Bevan University Health Board has made good progress against its financial improvement plan and achieved its agreed target control total for 2024-25. I have approved its three-year integrated medium-term plan for 2025-28, which will be subject to accountability conditions, in line with all other health boards.

The health board has met the de-escalation criteria for the finance, strategy and planning domain and I have therefore agreed advice to de-escalate it from level four to level three. The escalation levels for all other domains remain unchanged.

Betsi Cadwaladr University Health Board

Betsi Cadwaladr University Health Board remains at the highest level of escalation – at level five or special measures. 

I have published the latest progress report today, which sets out the improvements the health board has made, including in its financial position, in its corporate governance and quality improvements. There are clear signs the health board is starting to resolve many of its long-standing issues, but there are a wide range of performance issues – especially with planned care and urgent and emergency care – which must be gripped urgently.

Cardiff and Vale University Health Board

Over the last 18 months, the Cardiff and Vale University Health Board has reported an increasing financial deficit and has breached its duty to agree a three-year balanced plan.

It now has the second largest number of people waiting more than two years for treatment and there have been a series of worrying cultural and leadership challenges, mainly relating to the operating theatres and a high level of never events have been reported this year. 

These issues are concerning and are indicative of an organisation which needs additional support. I am today escalating Cardiff and Vale University Health Board to level four. This will enable us to support the health board to develop and implement the necessary improvements. 

We will work with the senior leadership team to assess capability and capacity of the organisation to deliver and implement the required improvements and support them to appoint a team with the appropriate skills and expertise. 

Cwm Taf Morgannwg University Health Board

Cwm Taf Morgannwg University Health Board delivered in-year financial balance in 2023-24 and 2024-25. I have approved its three-year integrated medium-term plan for 2025-28, which will be subject to accountability conditions, in line with all other health boards.

The health board has met the de-escalation criteria for the finance, strategy and planning domain and I have agreed advice to de-escalate it from level three to level one. The escalation levels for all other domains remain unchanged.

This is a significant achievement for the health board, which was put into special measures in April 2019 because of serious concerns about its maternity and neonatal services. In the last two years, the health board has been de-escalated to level one for maternity and neonatal services, quality and governance, leadership and culture and child and adolescent mental health services. 

The health board continues to make positive progress in relation to planned care and cancer performance.

Hywel Dda University Health Board

In March, I de-escalated the child and adolescent mental health service in Hywel Dda University Health Board from level four to level three. I am pleased to say these improvements have been sustained and I have de-escalated the service to level one – routine arrangements.

The health board has also made improvements in its cancer services and has met the agreed de-escalation criteria for the last three months, enabling me to de-escalate cancer services from level four to level three.

The escalation levels for all other domains remain unchanged.

Swansea Bay University Health Board

I am today increasing the escalation level of Swansea Bay's maternity and neonatal services to level four and will provide further details in a written statement.

NHS Wales Oversight and Escalation Framework

I have today published an updated version of the NHS Wales oversight and escalation framework.

These updates provide details about the level two escalation process, tidy up the escalation domains and provides greater clarity on the de-escalation process, including automatic de-escalation opportunities for those areas with quantifiable outcomes and targets to occur. When this happens, a written statement will be issued.

More information is available at: NHS Wales escalation and intervention arrangements | GOV.WALES