North Wales Health Board Halts Specific Vascular Surgeries, Relocating Them to England

Betsi Cadwaladr University Health Board has announced that certain major vascular operations will no longer be performed in north Wales. The health board stated it is temporarily suspending its provision of planned and emergency open abdominal aortic aneurysm (AAA) surgery to facilitate improvements in its other care services. The health board confirmed the occurrence of an “incident,” but clarified that this decision was not based solely on it, and other vascular care would proceed as usual. Approximately 10 to 15 patients annually will be required to travel across the border to England for their surgical procedures. Vascular services are dedicated to diagnosing and treating individuals experiencing issues with arteries, veins, or circulation, frequently serving patients with co-existing health conditions such as diabetes. An abdominal aortic aneurysm (AAA) refers to a localized enlargement in the aorta, which is the primary artery responsible for transporting blood from the heart throughout the body. This condition poses a life-threatening risk if not detected promptly. Carol Shillabeer, the chief executive, stated that the health board collaborated extensively with vascular specialists across Wales and the wider UK to arrive at its determination. She indicated that patients awaiting this particular surgery would have the option to undergo the procedure at the Royal Stoke University Hospital in Stoke-on-Trent “in the short term.” “Our collaboration with Stoke is long-standing and this builds on the strong partnership approach in place,” she commented. The health board announced it was reaching out to the “very small number” of affected patients to explore available options. It added, “We will always be transparent about the challenges of providing this very specialist element of vascular services to the north Wales population and this pause forms part of ongoing reviews to continue delivering safe services.” AAA surgery constitutes 0.2% of the yearly vascular service activity, the health board further noted, and approximately 6.5% of all vascular surgical procedures. Complex vascular services were consolidated at Ysbyty Glan Clwyd in April 2019, after previously being distributed between Ysbyty Gwynedd in Bangor and Wrexham Maelor Hospital. The service has faced examination since that time, and in 2022, the Royal College of Surgeons (RCS) identified risks to patient safety across multiple domains, concluding that, in certain instances, clinicians “were possibly working outside the limits of their competence.” During the same year, Health Inspectorate Wales (HIW) classified the service as “requiring significant improvement.” Last year, HIW downgraded that classification, noting that the standard of care was improving, although further enhancements were still necessary.