The Health Board has made strong progress on implementing our 2022 recommendations. Risk management training has improved, and there is stronger scrutiny of corporate risk registers. The Health Board now routinely reports on delivery and outcomes from clinical audit activity, and mortality reviews and learning processes have also improved. The Health Board has also reviewed its quality governance resources, strengthened clinical leadership, and provided more quality training opportunities to staff. However, the Quality and Safety Framework needs to be clearer on operational arrangements, updated to reflect the new organisational structure. Opportunities also remain to strengthen operational scrutiny of risk registers, embed the values and behaviours framework at an operational level and improve arrangements for staff to raise concerns. Clinical attendance at key quality and safety groups needs to be reinforced, and performance appraisal and development review (PADR) compliance rates also need to rise to meet targets. The Health Board has made satisfactory progress on embedding the statutory duties of quality and candour. Strategic planning, leadership commitment, and governance mechanisms are in place. However, monitoring of uptake of staff training on duty of candour needs to improve.