The Ministry of Health, Environment and Sustainability has published the independent diagnostic assessment of the Health Services Authority (HSA), completed by KPMG, making the report available to the public as part of the Ministry’s commitment to transparency and accountability.
The assessment began in January 2026 to provide an independent review of the HSA’s governance structures, leadership capability and operational effectiveness, and to identify practical opportunities to strengthen the Authority.
The review included stakeholder interviews, document analysis and surveys of HSA patients and caregivers, and staff and external partners. A total of 686 people participated in the survey process across Grand Cayman, Cayman Brac and Little Cayman.
The assessment identified 11 key challenges and 47 opportunities for improvements across five governance pillars;strategic vision and priorities, governance model and operational structure, performance management and accountability, collaboration and communition, and culture.
Minister for Health, Environment and Sustainability, Hon. Katherine Ebanks-Wilks, said publication of the report delivers on the commitment made when the assessment was announced in January.
“When we commissioned this assessment, I committed to making the findings available to the people of the Cayman Islands. Publishing the report in full is an important part of that commitment,” Minister Ebanks-Wilks said. “The purpose of this work has always been to provide a comprehensive, evidence-based assessment of the HSA’s governance arranagements, where improvements are required, and what actions need to be taken to strengthen the HSA. We now have an independent assessment and a clear set of recommendations to guide that work.”
The Ministry, HSA Board and HSA leadership will work together to develop a phased implementation plan to address the report’s recommendations, with responsibilities allocated according to their respective roles. The first step is the establishment of a Governance Implementation Steering Group within the next three months. The Steering Group will oversee implementation of the report's recommendations and coordinate actions across the responsible parties. Alongside this governance work, an independent clinical and operational review will be commissioned to provide an objective assessment of the Authority’s clinical services and operational performance.
Chief Officer for Health, Environment and Sustainability, Tamara Ebanks, said the publication of the report marks the transition from assessment to implementation.
“The value of this exercise will ultimately be measured by the actions that follow it. The report gives us an evidence base from which to strengthen governance, clarify responsibilities and improve accountability across the system. We will work with the HSA Board and leadership to ensure that recommendations are considered systematically, that responsibilities are clear and that progress can be monitored.”
The Ministry also acknowledged the HSA staff, patients, caregivers, external stakeholders and members of the wider community who contributed to the assessment.
“The level of participation, which included nearly 700 stakeholders, was important because the assessment needed to reflect the experiences of the people who work within the HSA, those who interact with it professionally and, importantly, the patients and families who rely on its services,” Minister Ebanks-Wilks said.
The Ministry is committed to providing further updates on implementation and progress against the recommendations as the work advances.
The KPMG Diagnostic Assessment of the Health Services Authority is available to the public at https://gov.ky/web/mhes/publications