Betsi Cadwaladr: Ministers asked to consider vascular inquiry

Vascular services were reorganised in April 2019, with complex procedures moved to Ysbyty Glan Clwyd

A senior coroner has asked the Welsh government to consider holding a public inquiry into vascular services at a troubled health board.

John Gittins said he wrote to the Welsh government to express "concerns" about the service provided by Betsi Cadwaldr University Health Board (BCUHB).

Seven weeks later, the coroner said he is yet to receive a response.

The Welsh government said on Friday that the health minister has now responded to the coroner.

Vascular services diagnose and treat people for problems with arteries, veins or circulation, and are often used by patients who have other health issues, such as diabetes.

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Mr Gittins, the senior coroner for north east and central Wales, is looking at the deaths of four vascular patients who died in 2021 after being treated at Ysbyty Glan Clwyd, Denbighshire.

The cases were referred to him in autumn 2022 following a clinical records review, after a report by the Royal College of Surgeons (RCS) found risks to patient safety.

Vascular services in north Wales have been under scrutiny since they were reorganised in 2019, with complex vascular services being centralised from Ysbyty Gwynedd in Bangor and Wrexham Maelor Hospital to Ysbyty Glan Clwyd.

Following the report by the RCS in 2022, Health Inspectorate Wales (HIW) categorised the services as "requiring significant improvement".

However, on Thursday that status was de-escalated by HIW after a further inspection found the quality of care had improved, though more progress was needed.

Betsi Cadwaladr manages NHS services and hospitals in Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire and Wrexham

Speaking at Thursday's pre-inquest hearing into the death of Robert Wyn Jones in 2019, Mr Gittins read out the letter he emailed to nine Welsh government ministers on 12 May 2023.

It said: "I'm presently conducting inquests into a number of deaths which have been referred to me whilst not concluded, would appear to relate to vascular treatment provided to the deceased by BCUHB and more specifically to the quality of care and treatment afforded to the deceased by the health board.

"In view of all the above circumstances, I feel duty bound to bring these matters to the attention of ministers so that they may give their consideration as to whether the provisions of Section 29 of the Inquiries Act 2005 now require there to be a public inquiry.

"In addition to the cases which are subject to inquest, members of the public from both legal and medical professions have also brought to my attention concerns which touch upon a variety of issues relating to the provision of vascular service in BCUHB."

The coroner also said in his letter he would be happy to provide more detailed information for such consideration.

A Welsh government spokesperson said: "[On Thursday] Health Care Inspectorate Wales found that improvements to the service had been made, but that more work was needed.

"We have commissioned an assurance review from the NHS Executive, which is under way.

"We remain concerned about vascular services at the health board and a number of pieces of work are currently underway about improving those services.

"We will await the outcome of that work before deciding if a public inquiry is needed."