Betsi Cadwaladr: Two more 'incidents' at health board

An arrangement to treat some vascular patients in Liverpool has been extended after two more "incidents".

This comes after two previous "concerning" incidents led to a plan to treat some north Wales vascular patients in England.

But the latest development has prompted Betsi Cadwaladr health board executives to take further measures.

The Welsh government said the health board needed to "address these service issues with immediate effect".

Details of the incidents the new incidents that led to the changes have not been disclosed.

But at a meeting of the board on Wednesday, executive medical director Dr Nick Lyons provided an update on the temporary move to treat patients in England, which was originally due to last 28 days.

"The continued close review of incidents rightly continues and since the start of the enhanced service, two further incidents have taken place that again rightly caused us to take stock and consider whether any further measures should be taken," he said.

Dr Lyons said the temporary arrangement would continue until 23 May, both due to the most recent incidents and to let teams plan their "service provision and rotas".

In a controversial move, complex vascular services were centralised from Ysbyty Gwynedd in Bangor and Wrexham Maelor Hospital, to Ysbyty Glan Clwyd in Denbighshire in April 2019.

In February 2022, the second of two critical reports by the Royal College of Surgeons was published.

Dr Lyons described staff morale as "very fragile", adding: "We have committed staff trying under sometimes quite difficult circumstances to offer the very best quality of care to their patients.

"When things go wrong, it is absolutely awful for the patients and their families, but also it's important to recognise the impact on our staff who come to work to do a good thing and are passionate about the care for their patients."

The temporary service model with Liverpool University Hospital NHS Foundation Trust (LUHFT) includes dual consultant operating for complex surgical procedures, a second consultant timetabled to be on call in the hub site during the week, a health board employed consultant who is on call overnight Monday to Friday, with any complex cases discussed with LUHFT and transferred out as appropriate as well as two consultants on call at weekends.

When the new model was introduced, it was expected that about four additional emergency procedures per week would take place at LUHFT, rather than Ysbyty Glan Clwyd, and about 20 surgeries and 60 outpatients appointments at the hospital would be delayed over the next month.

However, Dr Lyons told board members that no patient had needed to be transferred to Liverpool "to date" and the impact on surgeries and appointments "has not been as significant" as expected, but apologised to patients for the "disruption".

The Welsh government said: "We are seeking assurances from the board on a weekly basis on the effectiveness of this temporary service model.

"The support offered by the Liverpool University Hospital NHS Foundation Trust is welcome and will help the health board develop and deliver a sustainable solution."