Cardiff and Vale health’s boards systemic problems are unacceptable, says health minister

Written by independent advisors Prof Em Wilksinson-Brice and Dr Pamela Johnston, it focused on the root causes of existing problems – particularly critical were the findings on leadership and culture within the organisation.

The next phase of the intervention will consider how to resolve the issues raised.

The report stated “there is a lack of positivity, direction setting and clear decision-making” by the executive team.

It said the “financial narrative has been allowed to dominate the agenda at the expense of quality of care” and there was a “failure to focus on patient outcomes as the primary metric of success”.

Staff reported a “widely held belief.. that there is not the management capability to transform services” within the health board.

The report spoke of a failure to “reset” after Covid – where many experienced staff retired and there was a “management capability gap in the workforce”.

There was a “pervasive culture of learned helplessness” within the health board and a “lack of pace and urgency even when confronted with serious issues”, it continued.

It added there was a “lack of challenge” because people did not want to be unkind and a “background of insular, hierarchical and old fashioned views”.

Staff were interviewed anonymously for the report and described a “longstanding culture [over decades] of tolerance of poor behaviours including incivility, disrespect and poor team working, with a failure to tackle thee even when a whole team is negatively affected”.

Among the findings was a “digital immaturity” which “significantly hampers the progress” of the health board.

It said evidence shared with the advisors of “at least one manual process” where a patient was not followed up because a piece of paper posted under a door was lost.

There was a frustration expressed that as well as its local responsibilities, the health board provides highly specialised care for the wider population of Wales, and hosts the Major Trauma Centre for the country, but that contribution was not recognised in the funding model.

There was a “lack of agreement and communication for plans for the estate” – referring to crumbling hospital infrastructure and there was a “cultural disappointment and loss of faith in the pride many once felt” working for the health board.