NORTH Wales' health authority, which has now been in special measures for more than two and a half years, has admitted that a number of "significant challenges" remain.

A progress report, entitled Special Measures End of Phase 3 Overview, was presented at a meeting of the Betsi Cadwaladr University Health Board (BCUHB) at Venue Cymru in Llandudno earlier this month.

The special measures were introduced in June 2015 and the report gives an overview of progress made between December 2016 and November 2017.

It says: "In January 2016, the then Deputy Minister for Health issued a special measures improvement frame work to the health board, setting out expected improvement milestones over the next two years.

"These were divided into three phases in the following areas: leadership; governance; strategic and service planning; engagement; mental health; maternity services and primary care.

"Overall, in reviewing progress made across each phase since the health board was placed in special measures, up to the end of phase three, the task and finish group believes that some progress has been made, though significant challenges still remain.

"In terms of progress, the areas of greatest transformation since 2015 are under the leadership, governance, maternity services, primary care and engagement themes."

In the report, a number of "key achievements" were highlighted, including:

There now just being one interim role. During the first year of special measures, there were four executive roles with interim status, including the chief executive.

Improvements in clinical engagement through the implementation of a medical leadership structure in secondary care, appointments to the 'cluster leads' role in primary care and clinically led organisational development and clinically led strategy development work streams.

Other "successes" highlighted include a reduction in the need to take on locum doctors in maternity services.

By phase three, the overall medical staffing vacancy rate was 14.3 per cent, down from 43 per cent in 2015, and the new locum/rate was 11 per cent - down from 50 per cent and in Summer 2017, midwifery students have been re-introduced into Glan Clwyd Hospital.

An open visiting hours policy has been introduced across the health board. There has also been an increase in followers across the health board’s social media channels from 4,245 to 18,250.

The board say they recognise the "significant" scale of the ongoing challenge in improving mental health services across North Wales, although a new strategy for mental health services - Together for Mental Health - has been implements. This is a Welsh Government’s 10 year strategy to improve mental health and well-being; the 2016-19 delivery plan is the second of three action plans.

BCUHB was put into special measures following a damming report into the treatment of patients of the Tawel Fan mental heath ward at Glan Clwyd Hospital.

The report goes on to say: "In respect of the health board’s input into the wider governance review of older people’s mental health services led by Donna Ockenden, and the Health and Social Care Advisory Service (HASCAS) investigation into the concerns and complaints raised by members of the families of patients treated on Tawel Fan ward, it is acknowledged that both the review and investigations have taken longer than originally envisaged."

The Internal Tawel Fan Oversight Panel continues to meet to progress operational arrangements. The report stated - at the time of writing - the panel was overseeing the handling plan ahead of publication of the findings.

A Welsh Government spokesman said: "Progress has been made in some key areas under special measures but more is needed.

"Our focus is on taking action, investing and putting in place measures to ensure the improvements needed are addressed for the benefit of people in North Wales."