Wales’ healthcare inspectorate has again demanded “significant improvement” to the emergency department at Ysbyty Glan Clwyd. It is only two years since a similar order was lifted at the hospital after major patient safety concerns were identified.
Following an unannounced inspection in May 2026, concerns were raised about leadership, governance and risk management at the hospital’s busy emergency department in Bodelwyddan, Denbighshire.
Healthcare Inspectorate Wales (HIW) said it recognises that emergency care services face huge pressures. But the watchdog questioned whether Glan Clwyd’s systems, accountability and oversight were “sufficiently robust…. to reduce the risk of variation in care”.
HIW is now insisting on “urgent improvement” and has implemented “enhanced monitoring”. This will only be de-escalated once HIW is satisfied that Betsi Cadwaladr University Health Board (BCUHB) has taken suitable action.
BCUHB said it was taking steps to reduce overcrowding and improve patient safety at Glan Clwyd. It is also looking to boost staffing in all its emergency departments in North Wales. Sign up for the North Wales Live newsletter sent twice daily to your inbox
Glan Clwyd’s emergency department was previously designated a “Service Requiring Significant Improvement (SRSI)” in May 2022. It followed an unannounced inspection which revealed severe staffing shortages, patient safety risks with lengthy delays.
Inadequate oversight was given to high-risk patients and children in the hospital’s paediatric waiting area were said to be at “serious risk of harm”. Used underwear was found in storage and prescription-only medicines were left in unlocked cupboards.
Carol Shillabeer, chief executive of the North Wales health board
Also identified in 2022 was a lack of space to treat high numbers of seriously unwell patients. Meanwhile, doctors were left to come across high-risk patients instead of being alerted to them.
Follow-up inspections in late 2022 and early 2023 showed that while minor progress was made, long wait times and overcrowding issues persisted. HIW officially lifted the designation in August 2024 following marked improvements in patient assessments and waiting room management.
The Inspectorate now believes “the improvements made during that period have not been sustained”. As a result it has imposed a second SRSI at Glan Clwyd.
HIW chief executive Alun Jones said: “This designation means we expect clear and urgent improvement, supported by stronger oversight and accountability.
“While we recognise the pressures facing emergency departments, services must have effective arrangements in place to manage those pressures safely. We will continue to monitor progress closely and will report our full findings in September.”
Since the inspection, HIW has engaged with BCUHB and will continue to monitor progress through its Service of Concern process. This includes agreed actions and targets until HIW is satisfied that necessary improvements have been made.
HIW stressed that patients who need urgent or emergency care should continue to attend the department.
What the health board said
Carol Shillabeer, BCUHB’s chief executive, said the health board “fully accepts” the “serious concerns” identified at Glan Clwyd.
She said: “The issues relate to leadership and culture, patient safety, overcrowding and the safety and experience of patients waiting for care. We are sorry that, in some areas, the standard of care has not been where it needs to be for our patients.
“We know this will be concerning for the people we serve and for our staff, who are working under sustained pressure, and we want to reassure them that immediate action is underway.
“We have a clear understanding of the issues identified and a strengthened improvement plan is already being implemented with pace and strong oversight. This includes reducing overcrowding, strengthening patient safety, improving leadership and oversight within the department, and ensuring patients receive safe care from the point they arrive, including while they are waiting to be seen.”
Next week, BCUHB will also consider plans to improve staffing in all its emergency departments in North Wales. This will complement ongoing joint efforts to “address the structural issues of constrained patient flow and capacity”.
Ms Shillabeer added: “(These) are often the root cause of long waiting times, delayed ambulance handovers, and overcrowding within our emergency departments.
“These challenges cannot be addressed by the Health Board alone and we remain hugely grateful to our colleagues in local authorities and partner organisation for working with us to deliver the required improvements. Our focus is on delivering safe, timely and high-quality care for the people of North Wales.”
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