PFD report

David Colin Strachan · Prevention of Future Deaths report

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Issued 20 Feb 2023•North Wales (East and Central)

Report record

Published report and response evidence

This page connects the concerns raised in this report with statements found in recipients’ published responses. A link shows a clear evidence connection; it does not assign responsibility.

View original report
Concerns
2

Raised in this report

Recipients
2

Named on the report

Responses found
2

Of 2 recipients

Stated actions
25

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

Select any concern, action or position to view the source wording.

Concerns raised2

  1. Insufficient ambulance resource availability for timely attendance
    Part of recurring concern: Delays in ambulance attendancePart of recurring concern: Insufficient ambulance service capacity for emergency calls
  2. Delays in ambulance handover across BCUHB sites
    Part of recurring concern: Delays in ambulance-to-hospital patient handover
Responses linked to these concerns

Each statement is shown once, even when linked to more than one concern.

Actions described in response An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.4

  1. Action

    Conduct joint patient-safety incident reviews with the Welsh Ambulance Service and roll out the Health Board’s handover-review model.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  2. Action

    Implement the Integrated Commissioning Action Plan with partners to improve ambulance handovers.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  3. Action

    Continue monitoring, updating and presenting the Reducing Patient Harm Action Plan to the Trust Board.

    Stated by Welsh Ambulance Services NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.

Respondent positions A position is what a recipient says about a concern when it does not describe a specific action.1

  1. Position

    Some solutions to ambulance handover delays fall outside the Health Board’s control or require joint working across health and social care.

    Stated by Betsi Cadwaladr University LHBOutside remitThe respondent said that this matter was outside its role or authority.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Insufficient ambulance resource availability for timely attendance

Wider context from the report

“The causes of the ambulance delay were that all available resources were managing incidents of a higher acuity or the same category but registered prior and there were significant handover delays across all BCUHB sites. The matters of concern herein are longstanding and multifactorial and despite proposed future action significant concerns remain. The Welsh Ambulance Service NHS Trust and Health Board maintain that they are continuing to work closely in order to address handover delays and yet any improvements appear extremely limited. Deaths are occurring and will continue to occur as a result of delayed ambulance attendances caused by these multifactorial issues. ”

Is this part of a recurring concern?

Yes — Delays in ambulance attendance; Insufficient ambulance service capacity for emergency calls.

Open source report

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Delays in ambulance handover across BCUHB sites

Wider context from the report

“The causes of the ambulance delay were that all available resources were managing incidents of a higher acuity or the same category but registered prior and there were significant handover delays across all BCUHB sites. The matters of concern herein are longstanding and multifactorial and despite proposed future action significant concerns remain. The Welsh Ambulance Service NHS Trust and Health Board maintain that they are continuing to work closely in order to address handover delays and yet any improvements appear extremely limited. Deaths are occurring and will continue to occur as a result of delayed ambulance attendances caused by these multifactorial issues. ”

Is this part of a recurring concern?

Yes — Delays in ambulance-to-hospital patient handover.

Open source report

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Conduct joint patient-safety incident reviews with the Welsh Ambulance Service and roll out the Health Board’s handover-review model.

Verbatim wording from the response

“• Joint reviews between WAST and the Health Board of any patient safety incidents identified from handover delays to support joint working alongside the improvement programmes. The process within the Health Board has been identified as the gold standard model and being rolled out across Wales.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 5 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Implement the Integrated Commissioning Action Plan with partners to improve ambulance handovers.

Verbatim wording from the response

“• The ICAP (Integrated Commissioning Action Plan) is a joint piece of work with WAST/NCCU and the Health Board to support actions associated with improving ambulance handovers.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 5 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Continue monitoring, updating and presenting the Reducing Patient Harm Action Plan to the Trust Board.

Verbatim wording from the response

“The Trust has previously provided evidence to coroners pan-Wales regarding the actions that have been taken in order to reduce the lost hours and improve our response times for patients waiting in the community. In my response to you regarding Mrs. Glynis Roberts, I shared a copy of the Reducing Patient Harm Action Plan that had been tabled in our Trust Board meeting.”

Source location

Response from Welsh Ambulance Services NHS Trust
Page 2 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Revisit the Clinical Safety Plan to address patient-safety risks when ambulances are unavailable.

Verbatim wording from the response

“when ambulances are unavailable. Additionally, we have shared with you the measures that are currently in place such as the Clinical Safety Plan and the Regional Escalation Action Plan. I will not repeat those within this response to you, however, the Clinical Safety Plan was revisited in December 2022 and I attach at appendix 1, a copy of the latest plan.”

Source location

Response from Welsh Ambulance Services NHS Trust
Page 2 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Some solutions to ambulance handover delays fall outside the Health Board’s control or require joint working across health and social care.

Verbatim wording from the response

“The causes behind this issue are complex and long standing, exacerbated by the global COVID-19 pandemic. In many cases, the solutions sit outside of the Health Board or require joint working across the whole spectrum of health and social care.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 1 · response
Published 27 February 2023

Open published response

Other statements in published responses

These actions and other statements could not be clearly connected to one concern in this report.

Recipient-stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.21

  1. 1

    Recruit additional healthcare support workers for Tuag Adref and progress its domiciliary-care provider registration.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  2. 2

    Test care-home support and admission-avoidance arrangements, complete stakeholder engagement and prepare contracts.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  3. 3

    Continue driving technology support for the urgent and emergency care programme.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  4. 4

    Commission targeted care-home placements through block purchasing to provide step-down and step-up rehabilitation capacity.

    Stated by Betsi Cadwaladr University LHBStated completedThe respondent said that this action was complete when they made their response on 27 February 2023.
  5. 5

    Develop a seven-day discharge lounge and review lounge capacity to reduce restrictions.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  6. 6

    Implement national delayed-transfers-of-care census reporting with revised delay codes and validated data collection.

    Stated by Betsi Cadwaladr University LHBStated completedThe respondent said that this action was complete when they made their response on 27 February 2023.
  7. 7

    Review hospital full protocols and establish an acceptance benchmark.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  8. 8

    Finalise reporting and accountability arrangements for the Six Goals Programme across integrated health communities and stakeholders.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  9. 9

    Develop safe alternatives to admission through Same Day Emergency Care and Urgent Primary Care Centre services, addressing space and staffing needs.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  10. 10

    Support funding opportunities and identify high-risk patients to coordinate planning for people at risk.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  11. 11

    Progress local capacity schemes with local authorities to deliver additional beds or placements and develop further pipeline schemes.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  12. 12

    Hold a site-management and Emergency Department workshop to identify industrial-action learning that can become business as usual.

    Stated by Betsi Cadwaladr University LHBStated plannedThe respondent said that this action was planned when they made their response on 27 February 2023.
  13. 13

    Progress the Unscheduled Care Programme with the Six Goals Programme using appointed programme and clinical leadership capacity.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  14. 14

    Work with integrated health communities to support urgent and emergency care improvement initiatives aligned with the Six Goals Programme.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  15. 15

    Review urgent and emergency care provision in the community and collaborate on improvements.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  16. 16

    Operate a peripatetic Conwy service providing urgent short- and medium-term personal care and supporting hospital discharges.

    Stated by Betsi Cadwaladr University LHBStated completedThe respondent said that this action was complete when they made their response on 27 February 2023.
  17. 17

    Develop integrated action plans from census data to identify service gaps, themes and trends requiring funding or support.

    Stated by Betsi Cadwaladr University LHBStated plannedThe respondent said that this action was planned when they made their response on 27 February 2023.
  18. 18

    Operate the refreshed Health Board Six Goals Programme Group with agreed membership, terms of reference and meetings.

    Stated by Betsi Cadwaladr University LHBStated completedThe respondent said that this action was complete when they made their response on 27 February 2023.
  19. 19

    Develop an urgent improvement programme through an established task-and-finish group and report it through national and local governance arrangements.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  20. 20

    Monitor unscheduled-care performance metrics, including ambulance handover delays, through quality and performance reporting and Six Goals updates.

    Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 27 February 2023.
  21. 21

    Recruit micro-providers in Denbighshire to increase domiciliary-care provision.

    Stated by Betsi Cadwaladr University LHBStatus unclearThe respondent did not make the status of this action clear when they made their response on 27 February 2023.

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Recruit additional healthcare support workers for Tuag Adref and progress its domiciliary-care provider registration.

Verbatim wording from the response

“• The Tuag Adref (Homeward Bound) and District Nursing service in the West IHC is supporting with the provision of a number of packages of care where the local authorities have confirmed they are unable to provide within the required timeframe. A recruitment process has successfully appointed additional Health Care Support workers to Tuag Adref and the service is also in the process of becoming registered as domiciliary care provider with Care Inspectorate Wales (CIW).”

Source location

Response from Betsi Cadwaladr University Health Board
Page 4 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Test care-home support and admission-avoidance arrangements, complete stakeholder engagement and prepare contracts.

Verbatim wording from the response

“i) Working with our IHC teams to support initiatives for Urgent and Emergency Care improvement trajectories in line with the Six Goal Programme. ii) Support Welsh Government funding opportunities for high-risk patients – work is also ongoing within each IHC to identify high risk patients to co-ordinate planning for individuals at risk. iii) Support for patients within care homes and work on admission avoidance is being tested from January 2023 onwards. Stakeholder meetings are almost complete and contracts are being prepared. iv) Broader review of urgent and emergency care within the community which is underway with an appetite for collaboration.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Continue driving technology support for the urgent and emergency care programme.

Verbatim wording from the response

“v) Continued focus on safe alternatives to admission through Same Day Emergency Care units (SDEC) and Urgent Primary Care Centre developments, which are established but further work is underway to address space and staffing issues. vi) Continue to drive technology support for the programme.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Commission targeted care-home placements through block purchasing to provide step-down and step-up rehabilitation capacity.

Verbatim wording from the response

“Work is ongoing to commission targeted care home placements to provide specialist step down to recover rehabilitation beds and step-up, short-term rehabilitation support through block purchasing arrangements. Following an exercise to invite Expressions of Interest from over 300 residential and nursing care homes, responses were received from only 7 homes across North Wales totalling 35 placements. An evaluation process was undertaken of the applications received which resulted in 5 of the 7 homes being awarded contracts for a total of 21 additional placements, some of which were not suitable due to being under review by Care Inspectorate Wales or subject to escalating concerns. A further review will be undertaken once these circumstances change. It is also anticipated”

Source location

Response from Betsi Cadwaladr University Health Board
Page 4 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop a seven-day discharge lounge and review lounge capacity to reduce restrictions.

Verbatim wording from the response

“• Developing a 7 day discharge lounge in line with the 7 day NHS services commitment, and reviewing capacity of discharge lounges to reduce restriction.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 5 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Implement national delayed-transfers-of-care census reporting with revised delay codes and validated data collection.

Verbatim wording from the response

“A pilot was undertaken from November 2022 to January 2023 to reintroduce the national census reporting of the former delayed transfers of care (DTOC), which was stood down in early 2020 due to the pandemic. The reporting process has been refined with delay”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review hospital full protocols and establish an acceptance benchmark.

Verbatim wording from the response

“• A review is underway of the hospital full protocols and setting of a benchmark of acceptance.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 5 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Finalise reporting and accountability arrangements for the Six Goals Programme across integrated health communities and stakeholders.

Verbatim wording from the response

“The refreshed Health Board Six Goals Programme Group has been established with terms of reference, agreed membership and meetings in place which will be chaired by myself. A reporting framework and accountability arrangements within our IHC teams and associated stakeholders are being agreed and finalised.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop safe alternatives to admission through Same Day Emergency Care and Urgent Primary Care Centre services, addressing space and staffing needs.

Verbatim wording from the response

“v) Continued focus on safe alternatives to admission through Same Day Emergency Care units (SDEC) and Urgent Primary Care Centre developments, which are established but further work is underway to address space and staffing issues. vi) Continue to drive technology support for the programme.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Support funding opportunities and identify high-risk patients to coordinate planning for people at risk.

Verbatim wording from the response

“i) Working with our IHC teams to support initiatives for Urgent and Emergency Care improvement trajectories in line with the Six Goal Programme. ii) Support Welsh Government funding opportunities for high-risk patients – work is also ongoing within each IHC to identify high risk patients to co-ordinate planning for individuals at risk. iii) Support for patients within care homes and work on admission avoidance is being tested from January 2023 onwards. Stakeholder meetings are almost complete and contracts are being prepared. iv) Broader review of urgent and emergency care within the community which is underway with an appetite for collaboration.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Progress local capacity schemes with local authorities to deliver additional beds or placements and develop further pipeline schemes.

Verbatim wording from the response

“In line with the national 1000 beds campaign, work is continuing locally in partnership with the 6 local authorities across North Wales to progress a number of schemes identified to increase capacity. A total of 18 schemes are in place currently with trajectories that aim to deliver 221 additional beds or placements out of the required 243 target set for North Wales. Of the 18 schemes, 7 are amber where they are not currently on trajectory and 11 are green. Key challenges to delivery of the schemes is around recruitment of additional staff. Further pipeline schemes are also being worked in each county for additional capacity to achieve the 243 target and learning is being shared between our IHCs and the counties.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 4 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Hold a site-management and Emergency Department workshop to identify industrial-action learning that can become business as usual.

Verbatim wording from the response

“Local schemes were put in place to support the recent industrial action in December and January that had a positive outcome. Following on from this, there will be a site”

Source location

Response from Betsi Cadwaladr University Health Board
Page 2 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Progress the Unscheduled Care Programme with the Six Goals Programme using appointed programme and clinical leadership capacity.

Verbatim wording from the response

“The Unscheduled Care Programme within the Health Board is being progressed in conjunction with the Welsh Government Six Goals Programme for improving Urgent and Emergency Care. The Six Goals programme of work is being led by a recently appointed Programme Director working with a Clinical Improvement Lead and the Deputy Executive Medical Director, as the Senior Clinical Leads for the programme, supported by the Acting Associate Director for Urgent & Emergency Care.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Work with integrated health communities to support urgent and emergency care improvement initiatives aligned with the Six Goals Programme.

Verbatim wording from the response

“i) Working with our IHC teams to support initiatives for Urgent and Emergency Care improvement trajectories in line with the Six Goal Programme. ii) Support Welsh Government funding opportunities for high-risk patients – work is also ongoing within each IHC to identify high risk patients to co-ordinate planning for individuals at risk. iii) Support for patients within care homes and work on admission avoidance is being tested from January 2023 onwards. Stakeholder meetings are almost complete and contracts are being prepared. iv) Broader review of urgent and emergency care within the community which is underway with an appetite for collaboration.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review urgent and emergency care provision in the community and collaborate on improvements.

Verbatim wording from the response

“i) Working with our IHC teams to support initiatives for Urgent and Emergency Care improvement trajectories in line with the Six Goal Programme. ii) Support Welsh Government funding opportunities for high-risk patients – work is also ongoing within each IHC to identify high risk patients to co-ordinate planning for individuals at risk. iii) Support for patients within care homes and work on admission avoidance is being tested from January 2023 onwards. Stakeholder meetings are almost complete and contracts are being prepared. iv) Broader review of urgent and emergency care within the community which is underway with an appetite for collaboration.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Operate a peripatetic Conwy service providing urgent short- and medium-term personal care and supporting hospital discharges.

Verbatim wording from the response

“• Peripatetic service in Conwy set up to respond to urgent demand for provision of short to medium term personal care and support to individuals within their own homes, working closely with the reablement team to pick up new packages of care in the county and support hospital discharges.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 4 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop integrated action plans from census data to identify service gaps, themes and trends requiring funding or support.

Verbatim wording from the response

“codes amended to align with the revised pathways. This reporting process is a ministerial priority. The Health Board and the 6 local authorities are working together to ensure accurate data is inputted and validated. The process was implemented with go live from February 2023 onwards and the next phase of the reporting process going forwards will require integrated action plans to be developed to identify themes and trends to inform what gaps within services require funding and support. It is expected that these action plans will be reviewed through Health Board Unscheduled Care (Six Goals) Groups and also at the Regional Partnership Board.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 4 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Operate the refreshed Health Board Six Goals Programme Group with agreed membership, terms of reference and meetings.

Verbatim wording from the response

“The refreshed Health Board Six Goals Programme Group has been established with terms of reference, agreed membership and meetings in place which will be chaired by myself. A reporting framework and accountability arrangements within our IHC teams and associated stakeholders are being agreed and finalised.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop an urgent improvement programme through an established task-and-finish group and report it through national and local governance arrangements.

Verbatim wording from the response

“A task and finish group is established with support from the National Collaborative Commissioning Unit (NCCU) to develop an urgent improvement programme that will report into the National Ambulance Commissioning Group along with local NHS Wales Executive meetings that will support the Six Goals Programme for urgent and emergency care (detailed below).”

Source location

Response from Betsi Cadwaladr University Health Board
Page 3 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Monitor unscheduled-care performance metrics, including ambulance handover delays, through quality and performance reporting and Six Goals updates.

Verbatim wording from the response

“We closely monitor all the performance metrics related to unscheduled care, including ambulance handover delays, through our Integrated Quality and Performance Report which is received at the Health Board and its various Committees. The Health Board also receives regular updates on our improvement work in the Six Goals Programme.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 5 · response
Published 27 February 2023

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Recruit micro-providers in Denbighshire to increase domiciliary-care provision.

Verbatim wording from the response

“• Recruitment of micro-providers in Denbighshire to support increased provision of domiciliary care in the county.”

Source location

Response from Betsi Cadwaladr University Health Board
Page 4 · response
Published 27 February 2023

Open published response
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Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026