• Tawel Fan: Latest review on mental health 'chaos'

    A new report is expected to heavily criticise mental health services in north Wales later.

    An independent report published in May revealed chaotic and poor governance in how Betsi Cadwaladr health board delivered mental health care.

    This latest review looks at leadership and governance issues, sparked by problems found at Tawel Fan.

    The 17-bed elderly psychiatric ward closed in 2013 but an earlier inquiry rejected claims of abuse.

    The latest report is the second review by health official Donna Ockenden.

    Her first report was published in 2015 and included a family's claim that going to the ward - on the Glan Clwyd Hospital site near Rhyl - had been like visiting "animals in a zoo". She claimed there had been a lack of professional, dignified and compassionate care.

    But the subsequent independent inquiry, led by Dr Androulla Johnstone of the Health and Social Care Advisory Service (Hascas), was strongly critical of the way Ms Ockenden's review had been conducted and dismissed her central conclusion.

    Although it made major criticisms of the health board, it found no evidence of any wilful abuse and neglect despite an "extensive and thorough examination".

    and described it as a "whitewash", but the panel was unambiguous.

    It found serious failings in how mental health services were run, but on this particular ward - despite problems - some claims of physical abuse were based on misunderstandings and others from "misconceptions and falsehoods".

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    Months before Tawel Fan was closed in December 2013 amid claims of a "scandal", the health board - Wales' largest - was already in turmoil.

    Its chairman and chief executive both quit amid financial problems and "significant management failings". Despite changes at the top, two other reviews found the problems continued, particularly in mental health.

    The Hascas inquiry found that Tawel Fan, over three years, had been under huge pressure that was "unusual and all pervading".

    This included recruitment problems and having to deal with more admissions and more complex patients, who nursing homes did not want to look after.

    It said the "level of chaos and disruption" could not be underestimated.

    It found problems across the region, with elderly patients facing multiple ward moves, while "tribalism" was traced back to the health board's creation in 2009.

    Staff at Tawel Fan struggled to raise issues and there was more generally a "complete rift between board and ward" in how systems to deal with patient safety and quality improvement worked.

    The health board was put in special measures by the Welsh Government three years ago, with mental health one of its main areas to improve.

    Betsi Cadwaladr commissioned this second Ockenden report in the aftermath, but emphasises it will not be about the care and treatment of Tawel Fan patients.

    The health board stressed it will focus on "structures, systems and processes".

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