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I am pleased to update Members on our strategic plans for transforming access to urgent and emergency care, with the launch our Six Goals for Urgent and Emergency Care policy handbook covering the rest of this Senedd term.


The pandemic has had a substantial impact on our ability to deliver essential urgent and emergency care services. It is testament to the dedication and skill of clinicians, professionals and other staff throughout the health, social, third and independent sector that the majority of people who need these essential services continue to receive safe, effective and timely care.


The ongoing experience of the pandemic has accentuated the challenge but also reinforced opportunities for improvement. We must use this experience, learn from what matters to people when accessing urgent and emergency care and develop new community focused models of care. We must also support the health and social care workforce to develop through education and training, increase staffing capacity in crucial parts of the pathway and deliver tried and tested services consistently and reliably.


This handbook sets out our immediate priorities and expectations of Health Boards, NHS Trusts, Regional Partnership Boards, independent and third sector partners. We want to see people who need urgent or emergency care to receive the right care, in the right place, first time through consistent and reliable delivery of six goals. These are:


1. Coordination, planning and support for people at greater risk of needing urgent or emergency care
2. Signposting to the right place, first time
3. Access to clinically safe alternatives to hospital admission
4. Rapid response in a physical or mental health crisis
5. Optimal hospital care following admission
6. A ‘home\-first’ approach and reduce risk of readmission


Delivery of the six goals should support an improved urgent and emergency care experience for patients and staff, enable better outcomes and support achievement of value.


Members will note some milestones are medium or longer term in nature. This is in recognition of the additional complications presented by the pandemic, and its legacy, and the time it takes to train, recruit and place the right workforce in the best parts of the urgent and emergency care pathway to achieve our aspiration for right care, right place, first time. There is, however, active and ongoing action underway to achieve the milestones we have set.


We will support Health Boards and partners to deliver the six goals through a new national programme approach supported by additional funding and the following enabling work streams:


1. digital change, informatics and technology;
2. measurement for improvement and value based healthcare;
3. workforce education training and development; and
4. behaviour change, communications and marketing.


The following immediate national priorities are set out in the policy handbook:


* A focus on tackling health inequalities, ensuring *all* people across Wales can access, and are connected to, the support they need to remain independent, improve lives and outcomes;
* The use of NHS 111 Wales as the ‘front door’ for a 24/7 urgent care model, helping to signpost and schedule people with urgent care needs to the right care, in the right place, first time. This could be to new urgent primary care centres helping people avoid unnecessary trips to Emergency Departments;
* Developing strong, integrated community infrastructure and establishing same day emergency care services seven days a week and twelve hours a day to help people safely avoid admission to hospital;
* Establishing pathways to support optimal outcomes for people in physical and mental health crisis, and focusing on timely, safe and quality care in Emergency Departments; and
* A renewed focus on supporting people to return home from hospital when ready; reducing their length of stay to improve experience and outcomes and focusing on rehabilitation and reablement through an integrated health and social care approach.


I will provide an update on progress made through the six goals programme before summer recess.







Translation:


 
Mae’n bleser gen i roi’r wybodaeth ddiweddaraf i’r Aelodau ar ein cynlluniau strategol ar gyfer trawsnewid mynediad at ofal brys ac argyfwng, wrth inni lansio ein llawlyfr polisi ar y Chwe Nod ar gyfer Gofal Brys a Gofal mewn Argyfwng sy’n cwmpasu gweddill tymor y Senedd hon.


Mae’r pandemig wedi cael effaith ddofn ar ein gallu i ddarparu gwasanaethau gofal brys ac argyfwng hanfodol. Mae’n brawf o ymroddiad a sgiliau clinigwyr, gweithwyr proffesiynol a staff eraill ar draws y sector iechyd, gofal cymdeithasol, y trydydd sector a’r sector annibynnol bod mwyafrif y bobl sydd angen y gwasanaethau hanfodol hyn yn parhau i dderbyn gofal diogel, effeithiol a phrydlon.


Mae’r ffaith bod y pandemig yn parhau yn dyfnhau’r her, ond mae hefyd yn arwain at gyfleoedd i wella. Rhaid inni ddefnyddio’r profiad hwn, dysgu o’r hyn sy’n bwysig i bobl pan fyddant yn defnyddio gofal brys ac argyfwng a datblygu modelau gofal newydd sy’n canolbwyntio ar y gymuned. Rhaid inni hefyd helpu’r gweithlu iechyd a gofal cymdeithasol i ddatblygu drwy addysg a hyfforddiant, cynyddu’r capasiti staffio yn rhannau hanfodol y llwybr a darparu gwasanaethau profedig mewn modd cyson a dibynadwy.


Mae’r llawlyfr hwn yn nodi ein blaenoriaethau a’n disgwyliadau uniongyrchol ar gyfer Byrddau Iechyd, Ymddiriedolaethau’r GIG, Byrddau Partneriaeth Rhanbarthol, partneriaid annibynnol a’r trydydd sector. Rydym am weld pobl sydd angen gofal brys ac argyfwng yn derbyn y gofal iawn, yn y lle iawn, y tro cyntaf drwy gyflawni’r chwe nod canlynol mewn modd cyson a dibynadwy:


1. Cydgysylltu, cynllunio a chymorth i bobl sydd â risg uwch o fod angen gofal brys neu ofal mewn argyfwng
2. Cyfeirio pobl i’r lle iawn, y tro cyntaf
3. Dewisiadau eraill sy’n ddiogel yn glinigol yn lle mynd i’r ysbyty
4. Ymateb cyflym os oes argyfwng corfforol neu argyfwng iechyd meddwl
5. Darparu’r gofal gorau posibl i’r claf ar ôl iddo gael ei dderbyn i’r ysbyty
6. Dull ‘gartref yn gyntaf’ a lleihau’r risg o orfod mynd yn ôl i’r ysbyty


Dylai cyflawni’r chwe nod hwn arwain at brofiadau gwell i gleifion a staff o ofal brys ac argyfwng, canlyniadau gwell a helpu i sicrhau gwerth.


Bydd Aelodau’n sylwi bod rhai cerrig milltir yn rhai tymor canolig neu dymor hwy. Mae hyn yn codi o’r cymhlethdodau ychwanegol sy’n deillio o’r pandemig, a’i waddol, a’r amser mae’n ei gymryd i hyfforddi, recriwtio a lleoli’r gweithlu cywir yn rhannau gorau y llwybr gofal brys ac argyfwng er mwyn gwireddu ein huchelgais i gael y gofal iawn, yn y lle iawn, y tro cyntaf. Ond, mae camau gweithredol a pharhaus yn cael eu cymryd i gyrraedd y cerrig milltir rydym wedi’u gosod.


Byddwn yn cefnogi Byrddau Iechyd a phartneriaid i gyflawni’r chwe nod drwy raglen genedlaethol newydd a gefnogir gan gyllid ychwanegol a’r ffrydiau galluogi gwaith canlynol:


1. newid digidol, gwybodeg a thechnoleg
2. mesur ar gyfer gwella a gofal iechyd sy’n seiliedig ar werth
3. addysgu, hyfforddi a datblygu'r gweithlu
4. newid ymddygiad, cyfathrebu a marchnata.


Caiff y blaenoriaethau cenedlaethol uniongyrchol canlynol eu hamlinellu yn y llawlyfr polisi:


* Canolbwyntio ar fynd i’r afael ag anghydraddoldebau iechyd, gan sicrhau bod *pawb* ar draws Cymru yn gallu cael mynediad at, a chael eu cysylltu â’r cymorth sydd ei angen arnynt i barhau i fod yn annibynnol, gwella bywydau a chanlyniadau
* Defnyddio GIG 111 Cymru fel y cam cyntaf ar gyfer model gofal brys pob awr o bob dydd, gan helpu i gyfeirio pobl sydd ag anghenion gofal brys at y gofal iawn, yn y lle iawn, y tro cyntaf. Efallai mai i’r Canolfannau Gofal Sylfaenol Brys newydd fydd hyn er mwyn helpu pobl i osgoi gorfod mynd i Adrannau Brys yn ddi\-angen
* Datblygu seilwaith cymunedol cryf ac integredig a sefydlu gwasanaethau gofal brys ar yr un diwrnod saith diwrnod yr wythnos, deuddeg awr y dydd i helpu pobl i osgoi cael eu derbyn i’r ysbyty os yw hynny’n ddiogel
* Sefydlu llwybrau i helpu pobl i gael y canlyniadau gorau mewn argyfwng iechyd corfforol ac iechyd meddyliol, a chanolbwyntio ar ofal diogel, prydlon o ansawdd mewn Adrannau Argyfwng
* Ffocws newydd ar gefnogi pobl i ddychwelyd gartref o’r ysbyty pan fyddant yn barod; gan leihau hyd eu harhosiad yn yr ysbyty i wella profiad a chanlyniadau a chanolbwyntio ar adsefydlu a gwella drwy ddull gweithredu iechyd a gofal cymdeithasol integredig.


Byddaf yn rhoi’r wybodaeth ddiweddaraf am y cynnydd a wneir drwy’r rhaglen chwe nod cyn toriad yr haf.