BETSI Cadwaladr health chiefs have been urged by the Cabinet Secretary for Health to speed up an improvement programme aimed at bringing it out of special measures.

Vaughan Gething dropped into the health board's latest meeting in Wrexham to check on the progress made since it was told to up its game and hit targets in key areas of service delivery.

Originally, the board was told special measures, imposed in June 2015, would last for two years but after it repeatedly missed targets for standards a new phase of improvements was drawn up to run until June 2019.

Earlier this week Gething told the Welsh Assembly while the board had made improvements in some areas, he was "exasperated" with the pace of progress.

He said "significant challenges" remain as highlighted by the findings of two reports and he has set out milestones in four key areas: leadership and governance, strategic and service planning, mental health as well as primary care.

"I am intensely concerned with the decline in performance in these areas, and generally exasperated with the pace of progress by the health board on the milestones set for the first part of this calendar year and the continued lack of clarity on its plans for the future," he said.

"To ensure the health board delivers on its short and medium-term swiftly, I expect visible progress before the summer on the framework expectations, including a reduction in waiting times and recruitment to key positions completed."

A report to the board Betsi Cadwaladr Health Board cited progress reducing Referral to Treatment (RTT) waiting times by around 50 per cent for those patients waiting over 36 weeks. A turnaround director and team have also been appointed to aid the improvement process and an action plan agreed.

Mental health services are among the areas the Cabinet Secretary for Health says needs "urgent" attention and Andy Roach Director of Mental Health and Learning Disabilities, told the meeting a service review had taken place and new initiatives launched, including improving services for dementia patients.

Gill Harris, executive director of nursing, said the Dementia Strategy launched with Alzheimer's Society of Wales included improving communication between staff and dementia patients and their families during admissions.

It also enshrined the "right to stay" with loved ones during their time in hospital and working towards Dementia Friendly status in hospitals.

"We need to be clear of the impact dementia has on the wider family," she said. "We are going into acute hospitals as well as community hospitals to see what we can do better. For example the twiddle mitts initiative helps to release the anxieties and stresses that our patients have.

"And we are embracing fast-tracking patients through the emergency departments, although this is challenging."

Leslie Singleton, Director of Partnerships for Mental Health and Learning Disabilities, outlined how there was now a greater emphasis on services users, which had been helped by forging links with Caniad, the North Wales Area Planning Board for Substance Misuse.

She said: "We have put a governance structure in place that will take us to a next level. We are putting people at the heart of what we do. We have incredibly proactive and the approach we have will not just help our patients, but their carers and the wider public."

The Cabinet Secretary for Health said he was looking forward to maintaining his interest in the progress of special measures at Betsi Cadwaladr.

But Clwyd West AM Darren Millar says the board's improvements are "not being discerned by many patients" and questioned the improvements in mental health.

"Just a few weeks ago, we saw a report from an independent investigator which said that they couldn't guarantee that any patient would have a better experience now than patients on the Tawel Fan ward which was the subject of scandalous care some years ago," he said.