In February 2023, the Auditor General for Wales published a report in the public interest on the effectiveness of the board at Betsi Cadwaladr University Health Board, describing a worrying degree of dysfunctionality within the board and wider senior leadership.

The week following the publication of the Auditor General’s report on board effectiveness saw the Health Board placed back in special measures, and the resignation of all the board’s independent members.

A year later, our follow-up report reveals our findings on the effectiveness of the current board and the extent to which the areas for immediate action identified in our original report have been addressed.

Overall, we have found that following a period of significant disruption and churn during 2023, the board is now in a more stable position, a new chief executive is in post and working relationships amongst senior leaders are more positive.

However, some fundamental challenges remain in the context of an organisation that is in special measures.