Our work examined the robustness of the arrangements for overseeing and managing the contractual agreements established following the realignment of the health board boundaries in 2019.

Overall, we found that the contract arrangements are sound and supported by good operational oversight and project management.

However, there has been no clear programme for disaggregation of services until recently, and the lack of commissioning capacity and programme management, alongside the impact of COVID-19, has meant that the original timetable has not been met.

Oversight and scrutiny of the programme at Board and Committee level within both health boards also need to be improved, as well as the management of risk.