From Escalation to Improvement: a new NHS Wales white paper from people who have worked on the frontline of reform
NHS Wales is stuck in a “doom loop” of escalation. Breaking it doesn’t need new legislation, reorganisation or a new funding settlement, but a focused plan for improvement – starting with waiting lists.
In their new white paper ‘From Escalation to Improvement’, Perago, the former Hywel Dda chief executive Steve Moore and former Welsh Government Minister Lee Waters are urging Cabinet Minister for Health and Care, Mabon ap Gwynfor, to break the “doom loop” of escalation in NHS Wales.
The paper’s main recommendations are:
- published, measurable exit criteria for every escalated organisation, agreed at the point of escalation
- early support from an improvement partner, replacing “enhanced monitoring”
- fewer than ten national performance measures, down from 53, with a single reporting channel
- improvement made a standing item on every health board agenda, with stronger scrutiny from non-executive members and time for improvement built into consultants’ job plans
- one national elective programme, led by health board chief executives and medical directors, making better use of existing theatre capacity before building new
- Betsi Cadwaladr, escalated for the longest, as the first test of the new approach to escalation, with the elective programme starting in the boards most ready for it