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Posted: Thu 10th Sep 2026
Serious concerns over patient safety, leadership and governance have been found in an inspection of the emergency department at Ysbyty Glan Clwyd in Rhyl, with Healthcare Inspectorate Wales placing the department in the highest level of its escalation process for the second time in four years.
The unannounced inspection took place over three days in May, with HIW identifying what it called immediate assurance concerns requiring urgent action by Betsi Cadwaladr University Health Board, which runs the hospital.
Inspectors found that some patients with high clinical risks were not always moved promptly to monitored clinical areas, and that oversight of patients in the waiting area was not sufficiently reliable.
In the department’s paediatric area, inspectors found the children’s section had at times been left unattended while patients were present, and identified an absence of paediatric trained nurses along with weaknesses in security arrangements.
Inspectors also found expired and missing emergency equipment, and inconsistent completion of safety checks.
More than 660 patients, relatives and carers responded to a HIW survey, describing long waiting times, overcrowding and issues with privacy and dignity, while also praising the compassion and professionalism of staff.
HIW said longstanding risks, including overcrowding, corridor care, delays in patient flow, workforce pressures and risks to patient dignity, had become normalised “despite being recognised through governance arrangements, incident reporting, staff feedback and previous scrutiny.”
The department was designated a Service Requiring Significant Improvement, the highest level of escalation under HIW’s Service of Concern process.
It was previously under the same designation between May 2022 and August 2024, and HIW said this latest inspection found that improvements made during that earlier period had not been sustained.
HIW said the decision was not based on service pressure alone, but reflected concerns over whether leadership, governance and oversight arrangements were effective enough at identifying and reducing risks to patients and staff.
A follow-up visit on 24 and 25 August found improvements in staff wellbeing, patient flow, safety huddles, paediatric governance, security, and the management of medicines and equipment.
HIW said challenges remained around oversight of the waiting room and delays in getting specialist input following referrals, and that continued focus would be needed to sustain the improvements made.
Alun Jones, Chief Executive of Healthcare Inspectorate Wales, said: “People attending emergency departments should be able to expect safe, timely and dignified care, particularly when they are at their most vulnerable.”
He said the inspection had found “serious concerns about patient safety, patient flow, leadership, governance and the effectiveness of the arrangements in place to identify, manage and reduce risks to patients and staff.”
Mr Jones said the recurrence of previously identified issues “raises important questions about the effectiveness of the arrangements in place to identify, manage and reduce risk.”
Carol Shillabeer, Chief Executive of Betsi Cadwaladr University Health Board, said: “As a Health Board we apologise unreservedly to those patients who didn’t receive the care they deserve, as highlighted by Healthcare Inspectorate Wales during their inspection of the Emergency Department in May 2026.”
She said all required actions from the report were “now underway within the department and elsewhere in the hospital.”
Ms Shillabeer said the health board recognised “significant and longstanding systemic issues” and was “committed to assuring HIW and our public that we are serious about improving people’s experiences in our EDs by embedding progress into long-term, sustainable change.”
Darren Millar MS, the Welsh Conservative leader and Clwyd MS, called for Ms Shillabeer to be sacked, saying: “It is clear that the current Chief Executive is simply not up to the job. It’s time for her to go.”
Mr Millar said the health board’s special measures arrangements, in place since 2015, “aren’t working,” and called for an independent review.
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