Cwm Taf Morgannwg University Health Board's arrangements for checking on the quality and safety of patient care have improved significantly
Audit Wales and Healthcare Inspectorate Wales (HIW) have published a joint report which describes the progress made by Cwm Taf Morgannwg University Health Board in strengthening its quality governance arrangements following our original joint review work in 2019.
Our 2019 joint report highlighted a number of fundamental weaknesses in the Health Board’s arrangements in respect of leadership, strategic focus and scrutiny of patient safety and risk, management of concerns and complaints, and organisational culture. We were concerned that these weaknesses were compromising the Health Board’s ability to identify and respond to problems with the quality and safety of patient care. Our 2019 report made a total of 14 recommendations for improvement.
Our follow-up review found the Health Board has made significant progress in addressing the concerns and recommendations of our 2019 report. It has a stronger strategic focus on quality and patient safety, and there is greater clarity on roles and responsibilities in relation to quality and patient safety compared to 2019.
The organisation’s scrutiny of quality and patient safety has also improved considerably, with greater openness and transparency. There is also greater awareness of risk management across the organisation, and clearer processes in place for identifying, managing, and escalating risks. The Health Board’s concerns and complaints processes are much clearer, and new corporate roles have been created to support implementation and ensure consistency. There is also an improved culture of learning, with a series of arrangements now in place to support the sharing of learning and improvement across the organisation.
There is early evidence of the Health Board’s new operating model supporting further improvements in organisational culture, but further work is required around establishing clear performance monitoring and management arrangements within the new structure.
Staff told us that internal culture is improving, and senior leaders are more visible and accessible. However, they also told us that there are still areas for improvement, particularly in relation to addressing pockets of poor behaviour.
Overall, this is a positive achievement and a clear demonstration of the health board’s commitment, drive, and desire to address our concerns in full and put things right. Nevertheless, the health board still needs to take further action to fully embed its revised quality governance arrangements across the organisation and implement all remaining recommendations in full. Together with Audit Wales we will continue to closely monitor their progress.
It is pleasing to see the positive progress the Health Board has made in addressing the significant concerns and weaknesses we identified in our 2019 report. The improvements which we are describing today mean the Health Board is much better placed to know if its services are safe and of good quality. These improvements must now be sustained and built upon as the Health Board completes the implementation of the recommendations we made in 2019.