The Betsi Cadwaladr University Health Board (BCUHB) is the largest single health organisation in Wales, and is responsible for providing community, hospital and mental health services, and overseeing primary health care services for a population of around 680,000 people in North Wales, together with providing some services to residents of North Powys and parts of Cheshire and Shropshire. The services are provided from three acute hospitals: Ysbyty Gwynedd (YG) in Bangor; Glan Clwyd Hospital near Rhyl (YGC); and Wrexham Maelor Hospital (YMW), along with a network of community hospitals, health centres, clinics, mental health units and community team bases. We employ approximately 16,000 staff, and also coordinate the work of 191 general practitioner (GP) practices, and National Health Service (NHS) services provided by dentists, opticians and pharmacists across the region. BCUHB was established on 1 October 2009 as a part of the Welsh Government One Wales reform programme for the NHS in Wales, bringing together three acute and several community hospitals, along with six primary care commissioning area units as a single provider. The reconfiguration provided great opportunity for closer working together by multiple organisations in the north of Wales to provide best possible and specialist care for our patients. The greatest constraint, similar to any mixed urban/rural population, is geographical – presenting confounding issues in respect of having adequate critical mass to support sub-specialist care provision while maintaining acceptable access times for the majority of patients.
For Pathology services across North Wales, a single managed service was created to replace the three individual hospitalbased departments. With the relatively low requirement for direct patient access to laboratory-based Pathology services, the opportunity existed to re-provide these services in a more specialist, concentrated form. During the period 2010–2015, several business cases were approved and implemented, to support this vision, providing new/refurbished premises, specialist laboratory equipment and IT technologies to improved both quality and performance of essential investigations and tests.
Cellular pathology in North Wales
For Cellular Pathology services, the outcome of this major reconfiguration was a merge of the three small cellular pathology departments into one single managed central laboratory based in Glan Clwyd Hospital site near Rhyl; a new, purpose-built laboratory and accommodation for up to 12 medical staff and their secretarial teams. The service operates principally from the Glan Clwyd site, with currently sample reception, mortuary, and minimal consultant/ secretarial accommodation and facilities remaining at the Ysbyty Wrexham/Ysbyty Gwynedd sites. The new single Cellular Pathology service annually processes:- 44,000 histopathology requests
- 5000 non-cervical cytology requests
- 50,000 cervical cytology requests.
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