Translate the text from English to Welsh.



 
Members may recall that earlier this year the Children’s Commissioner for England published a report “Far less than they deserve”, raising concerns about children with learning disabilities/autism in mental health hospitals in England.


As a result of these findings I sought an assurance from the Welsh Government’s Chief Nursing Officer/Nurse Director, NHS Wales that appropriate admission arrangements and care pathways are in place for any children from Wales who may be placed in specialised hospitals in England as part of these arrangements.


In May 2019 the Chief Nursing Officer commissioned the NHS Wales National Collaborative Commissioning Unit to undertake a national care review of children receiving specialised hospital care in England. It was intended that the review would cover Child and Adolescence Mental Health in patient services (CAMHS) commissioned from external (not NHS Wales hospitals) providers such as NHS England or the independent hospital sector.


This focus of the national care review was intended to ensure that children were receiving:


* Care for the minimal time required in the right environment to meet all needs.
* Care which empowers, enables and involves.
* The right level of support to reduce risk, promote independence and improve quality of life.
* Prescribed medication at the minimum dose required to achieve the identified clinical outcomes and that side effects were being closely monitored.
* Safe, effective and high quality care, with minimal use of restraint or other restrictive practices.
* Outcome\-focussed interventions by a range of skilled and experience staff.


The clinical review team visited 11 children placed in NHS and independent provider units in England. This covered low, medium, secure, psychiatric intensive care and acute wards. The review looked in depth at the appropriateness of the placement, the quality of care and the impact of that care for the children.


At the time of the review, 9 of the 11 children were considered to be in an appropriate placement with two children considered ready to move to a lower level of dependency. In terms of the quality of care, I am reassured that the review identified areas of good practice across a number of domains including: staff, care planning, medication, physical health checks, therapeutic interventions, safety and welfare, education and nutrition. Those areas that require improvement have been identified and, where necessary, providers have been given remedial action plans to address any remaining concerns.


At October 2019, 5 children remain in the same hospital at which they were reviewed, 3 children remain in hospital but have been transferred to a more local facility and one child is awaiting transfer to an NHS Wales facility. 2 children have been discharged from hospital.


The NHS Wales National Collaborative Commissioning Unit review team has ensured all findings have been shared with the providers and are now monitoring the remaining placements.


A copy of the review report can be accessed through the following link:


National care review of Child and Adolescent Mental Health Services (CAMHS) provided outside Wales







Translation:


 
Efallai y bydd yr Aelodau’n cofio i Gomisiynydd Plant Lloegr gyhoeddi’r adroddiad “*Far less than they deserve*” yn gynharach eleni. Roedd yr adroddiad hwnnw’n codi pryderon ynghylch plant ag anawsterau dysgu/awtistiaeth sydd wedi eu lleoli mewn ysbytai meddwl yn Lloegr.


O ganlyniad i’w gasgliadau, ceisiais sicrwydd gan Brif Swyddog Nyrsio Llywodraeth Cymru/Cyfarwyddwr Nyrsio GIG Cymru fod trefniadau derbyn a llwybrau gofal priodol ar waith i unrhyw blant o Gymru a allai gael eu lleoli mewn ysbyty arbenigol yn Lloegr fel rhan o’r trefniadau hyn.


Ym mis Mai 2019, cafodd Uned Comisiynu Gydweithredol Genedlaethol GIG Cymru ei chomisiynu gan y Prif Swyddog Nyrsio i gynnal adolygiad gofal cenedlaethol mewn perthynas â phlant sy’n derbyn gofal mewn ysbytai arbenigol yn Lloegr. Bwriad yr adolygiad oedd edrych ar wasanaethau iechyd meddwl plant a’r glasoed (CAMHS) i gleifion mewnol sydd wedi eu comisiynu oddi wrth ddarparwyr allanol (nad ydynt yn ysbytai GIG Cymru), megis GIG Lloegr neu’r sector ysbytai annibynnol.   


Nod yr adolygiad gofal cenedlaethol oedd sicrhau bod plant yn cael y canlynol:


• Gofal am yr amser gofynnol mewn amgylchedd priodol sy’n gallu bodloni eu holl  


  anghenion.


• Gofal sy’n grymuso, yn galluogi, ac yn ymgysylltu. 


• Y lefel gywir o gymorth ar gyfer lleihau risg, meithrin annibyniaeth, a gwella ansawdd 


   bywyd. 


• Meddyginiaeth a ragnodir ar y dos lleiaf y mae ei angen i sicrhau’r 


   canlyniadau clinigol a nodir, a bod unrhyw sgil effeithiau’n cael eu monitro’n drylwyr.


• Gofal diogel, effeithiol o ansawdd da, gan ddefnyddio cyn lleied â phosibl o ataliaeth 


   neu arferion atal eraill.


• Ymyriadau sy’n canolbwyntio ar ganlyniadau gan amrywiaeth o staff sydd â’r  sgiliau 


   a’r profiad priodol. 


Ymwelodd y tîm adolygu clinigol ag 11 o blant a oedd wedi eu lleoli mewn unedau o eiddo’r GIG a darparwyr annibynnol yn Lloegr. Roedd y rhain yn cynnwys wardiau gofal seiciatrig dwys ac acíwt lefel isel, canolig a diogel. Roedd yr adolygiad yn edrych yn fanwl ar ba mor briodol oedd y lleoliad, ansawdd y gofal, ac effaith y gofal hwnnw ar y plentyn.


Adeg yr adolygiad, ystyriwyd bod naw o’r un ar ddeg o blant mewn lleoliad priodol, ac ystyriwyd bod dau blentyn yn barod i symud i lefel is o ddibyniaeth. O ran ansawdd y gofal, rwyf wedi fy sicrhau bod yr adolygiad wedi nodi nifer o wahanol feysydd lle’r oedd arferion da ar waith, gan gynnwys meysydd staffio, cynllunio gofal, meddyginiaeth, archwiliadau iechyd corfforol,  ymyriadau therapiwtig, diogelwch a llesiant, addysg, a maeth. Mae’r meysydd hynny lle mae angen gwella wedi cael eu nodi, ac mewn achosion priodol rhoddwyd cynlluniau unioni iddynt eu gweithredu er mwyn rhoi sylw i unrhyw bryderon a oedd yn parhau.  


Ym mis Hydref 2019, mae pum plentyn yn parhau yn yr un ysbyty lle y cawsant eu hadolygu, mae tri yn parhau mewn ysbyty ar ôl cael eu trosglwyddo i gyfleuster mwy lleol, ac mae un plentyn yn aros i gael ei drosglwyddo i gyfleuster sy’n eiddo i GIG Cymru. Mae dau blentyn wedi cael eu rhyddhau o’r ysbyty.  


Mae tîm adolygu Uned Comisiynu Gydweithredol Genedlaethol GIG Cymru wedi sicrhau bod yr holl ganlyniadau wedi cael eu rhannu â’r darparwyr, ac mae bellach yn monitro’r lleoliadau sy’n parhau.


I weld copi o adroddiad yr adolygiad, cliciwch ar y ddolen ganlynol:


https://llyw.cymru/adolygiad\-gofal\-cenedlaethol\-o\-wasanaethau\-iechyd\-meddwl\-plant\-ar\-glasoed\-camhs\-ddarperir\-y\-tu