NHS: Is Betsi Cadwaladr top job the toughest in Wales?

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NHS: Is Betsi Cadwaladr top job the toughest in Wales?

Taking on the role of chief executive of Betsi Cadwaladr health board, Wales’ largest and most troubled health board, was no easy feat for Carol Shillabeer. She became the temporary boss in May 2021 after 11 independent board members were forced to resign, and has since been tasked with solving a plethora of core issues and removing labels of a failing organisation.

The challenges facing the NHS in north Wales are significant, with patient safety failings, poor performance, staff shortages and governance issues being prevalent for over a decade. In fact, Shillabeer is the eighth interim or permanent chief executive to take on the role in the past 11 years.

Despite these challenges, there have been inroads made towards solving some of the most pressing issues. Waiting lists for orthopaedic treatment have been reduced, with 40% fewer patients waiting for more than a year compared to the summer of last year. This has been achieved by centralising some hip and knee procedures at Abergele Hospital in Conwy where surgery is less likely to be postponed than at larger hospitals due to a lack of pressure from emergency care or A&E. Patients also now have access to occupational therapists and physiotherapists before and after surgery to help them return home within a day rather than spending weeks in the hospital.

While these improvements have been lauded by patients, Ms Shillabeer is fully aware that there is much more work to be done to improve Betsi’s reputation as a struggling health board. She recognises that the health board needs stability and her role is to start laying the foundations for the future, although she acknowledges her job is complex and there is a history of the health board being in and out of special measures.

Financial management and budget pressures are also among the challenges facing Betsi Cadwaladr. The health board has been asked to make significant financial savings, with a £134m deficit expected by next spring. Ms Shillabeer admits that this feels unprecedented and has suggested that she may need to save money by not filling vacancies in the short term

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