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Performance of Betsi Cadwaladr Health Board

by Owen Donovan

September 3, 2026

in Health & Social Care, Issues

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Image Source: Betsi Cadwaladr University Health Board via LinkedIn

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Performance of Betsi Cadwaladr Health Board

Is this devolved to Wales?

Where is this happening?

What's happening?

Why is this happening?

Who has been affected?

What's happening?

Why is this happening?

Who has been affected?

Note: A “pathway” means a course of treatment, not a patient. Each patient may be on several “treatment pathways” at the same time.

NHS waiting lists: pathways waiting one year and two years, Betsi Cadwaladr Health Board (custom table; May- 2025-May 2026)

Emergency departments: performance against waiting times targets, May 2025-May 2026 (performance against 4 hour target, Percentage of patients who spend less than the target time in an emergency department)

Cancer waiting times: patients starting treatment and patients informed they do not have cancer, May 2025-May 2026 (percentage of patients starting their first treatment within 62 days of first being suspected of cancer)

Diagnostic services: pathway waiting times, August 2024 onwards (January 2026-May 2026), pathways with waits more than 8 weeks for diagnostic services

Some data was unavailable for certain months (Cwm Taf Morgannwg, March 2026), while Powys Teaching health board has been discounted as it’s waiting lists are in single or double digits.

£ 2.21 billion

Annual expenditure by the health board during 2023-24 (primary and secondary care)

Who has raised this at the Senedd?

Mabon ap Gwynfor MS

Health & Care Minister

Elfed Williams MS

Backbencher

Becca Martin MS

Backbencher

Beca Brown MS

Backbencher

Marc Jones MS

Backbencher

Dan Thomas MS

Backbencher

James Evans MS

Chair: Environment & Rural Affairs

Cristiana Emsley MS

Shadow Communities Minister

Nigel Williams MS

Backbencher

Ken Skates MS

Labour Group Leader

Janet Finch-Saunders MS

Backbencher

Natasha Asghar MS

Backbencher

Darren Millar MS

Conservative Group Leader

Sam Rowlands MS

Chair: Finance

Mabon ap Gwynfor MS

Health & Care Minister

Elfed Williams MS

Backbencher

Becca Martin MS

Backbencher

Beca Brown MS

Backbencher

Marc Jones MS

Backbencher

Dan Thomas MS

Backbencher

James Evans MS

Chair: Environment & Rural Affairs

Cristiana Emsley MS

Shadow Communities Minister

Nigel Williams MS

Backbencher

Ken Skates MS

Labour Group Leader

Janet Finch-Saunders MS

Backbencher

Natasha Asghar MS

Backbencher

Darren Millar MS

Conservative Group Leader

Sam Rowlands MS

Chair: Finance

What are the party positions on this?

Plaid Cymru backbenchers see this as an inherited problem but are keen to see action to address failings at the health board.

In Betsi Cadwaladr, for too long, the story has been one of special measures and inconsistency in service standards. I am concerned to see, as an example, the accident and emergency department at Glan Clwyd Hospital being identified as a service that needs significant improvement by Healthcare Inspectorate Wales just last week. This isn't a criticism of staff, but of a system where there is lack of clarity in terms of accountability and consistent leadership.

Betsi Cadwaladr University Health Board has spent much of its existence under some form of special measures. There's a well-documented history of cultural challenges and mismanagement within the health board, which underlines the urgent need for a fundamental shift. We must move away from the cycle of reactive crisis management and instead embed a culture that is performance driven, transparent and genuinely accountable.

The situation at Betsi Cadwaladr University Health Board is a clear reflection of the systemic weaknesses that have accumulated over a long period of time under the previous Government. There's been failure for over a decade to ensure that care is delivered in the right place, particularly in community settings, which has led to significant pressures on hospitals and, unfortunately, to worse outcomes for patients. As a result, we've seen a familiar cycle developing: a lack of capacity in the community, increasing demand on services in general hospitals, and then the need to respond to emergencies rather than prevent them.

Reform UK are calling for details on urgent actions the Welsh Government intends to take, and remains sceptical that the new administation will do anything radically different from previous governments. At least one MS has suggested drafting in English NHS trusts to run the health board.

Minister, babies have been born, started school and reached secondary education during the time Betsi Cadwaladr has been in special measures. If special measures can last for more than 11 years, they are no longer special measures, they are business as usual. Whatever Government was in office when they began, your Government now owns them. North Wales patients have heard over 11 years of assurances. Why should they believe that this time is any different?

....the figures remain deeply concerning. Only 58.2 per cent of emergency department patients at Betsi were admitted, transferred or discharged within four hours, and 17.1 per cent waited more than 12 hours. On planned care, 18.6 per cent of pathways were waiting more than a year. Diagnostics were also a major problem, with 43 per cent of pathways waiting longer than the eight-week target. Cancer performance stood at 52.5 per cent against the 62-day target, far below the 75 per cent target that the Welsh Government sets itself.

I've been contacted, actually, by a staff member at Wrexham hospital who described what they believe to be a culture of bullying and intimidation within parts of the senior management structure at the Betsi Cadwaladr University Health Board, and that may be at the heart of some of the issues that are actually ongoing here. They tell me that staff have been driven to sickness, have resigned or have sought transfers elsewhere because they feel unsupported and were still unable to challenge poor behaviour.

Labour MSs support action to improve the health board’s performance, but want more detail on what the Welsh Government plans to do differently to what they did.

It feels and sounds like you're frustrated with the escalation framework ....we're not seeing the improvements and the speed of improvements that should be expected at that point on the escalation scale. So, I understand and appreciate why you are taking these measures, but what I'm concerned about is that the measures have been deployed in the past, albeit in different forms. Largely, intervention has been seen in the past to little or no avail, or at least to no sustained benefit for the long term.

Conservative MSs appreciate that the Health Minister’s desire to see a turnaround is genuine, but they want action to be taken urgently instead of being held up by more consultations and reviews.

.....what people want to see is concrete action to deliver improvements. We know that one of the things that people are absolutely desperate for is increased capacity, bed capacity in particular, in order to address the problems in the emergency department, which, of course, today, has been designated as a service requiring significant improvement by Healthcare Inspectorate Wales. What action are you going to take to urgently review the paltry number of beds proposed for the new north Denbighshire community hospital in Rhyl, which is fewer than half the beds originally proposed 13 years ago, when the problems now at the nearby Glan Clwyd Hospital are more acute than ever?

I support your passion to turn things around at the board, and I agree that time is of the essence when it comes to Betsi Cadwaladr University Health Board, given that it's been in special measures for 11 years. I also agree that the board's issues are complex and varied. I wonder, though, Cabinet Minister, how your approach will, indeed, help to find a better outcome. It feels like reviews on issues that have already been reviewed are undergoing regular reviews, which seems like kicking the can down the road for me.

Green MSs haven’t said anything on this yet.

Test Test Test

Jane Dodds hasn’t said anything on this specifically.

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Who is responsible?

Mabon ap Gwynfor MS

Health & Care Minister

What have ministers said?

We are not simply asking the organisation to improve; we are directing them on how that improvement happens. That means setting clear expectations, providing targeted expertise, and maintaining close and continuous oversight of delivery. It also means there are no second chances for those in positions of responsibility and authority. The era of plans for improvements being allowed to drift, of problems being allowed to fester, undermining the interests of patients and staff, ends now. It is also a clear statement of my commitment to supporting improvement and ensuring people in the north of Wales receive the safe, high-quality and timely care that they deserve.

I recently met with the chair and chief executive of the health board during a visit to Ysbyty Glan Clwyd, and set out my expectation that they must take ownership of the long-standing issues within the health board and make the improvements required for the people they serve. I've also written to the chair of the health board setting out my concerns about the lack of progress. And, in July, I will chair a meeting with members of the health board's executive team and board to make clear to them my expectations in terms of improvements.

What's being done about this?

What do the Welsh Government want to do?

Does this need a new law or regulations?

How long will this take?

What do the Welsh Government want to do?

Does this need a new law or regulations?

How long will this take?

What have the Senedd's Committees said?

Nothing has been discussed yet.

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Relevant Votes

Nothing to see yet.

Further Reading

Jenny Rees, BBC Wales (30th June 2026). “Final warning for failing Betsi Cadwaladr University health board“
Welsh Government (29th September 2026). “New approach to give NHS Wales earlier support”

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