Translate the text from English to Welsh.



 
In recent months, the Independent Maternity Services Oversight Panel (IMSOP), which was set up to oversee improvements in maternity and neonatal care at Cwm Taf Morgannwg University Health Board, has increased its focus on neonatal care.


In March, Dr Alan Fenton, a consultant neonatologist and Ms Kelly Harvey, a neonatal nurse, joined the panel. In May, supported by a small team of clinical reviewers, it began a deep dive review into the neonatal service at Prince Charles Hospital, in Merthyr Tydfil. The terms of reference were agreed with the health board, which welcomed this development. The aim was to take stock of the current neonatal service and the existing improvement plan to seek assurance that services are safe, effective, well led and importantly, integrated with maternity to provide a seamless service for women and babies.


This comprehensive exercise is being informed by evidence gathered from a range of sources including:


* Feedback from families who have experienced neonatal care, with more than 100 families responding to a listening exercise the panel undertook during July.
* Conversations with staff and wider stakeholders.
* Case reviews of the sickest infants presenting to the neonatal unit during 2020\.
* A review of a wide range of documentation relating to clinical outcomes, safety and effectiveness data as well as clinical governance and assurance.


From the evidence reviewed to date, the panel has identified some areas, which it determined were impacting on the consistent provision of safe and effective care that would be expected of such a unit in the UK.


It took the decision to advise the health board of its interim findings and escalate a range of issues for immediate and short\-term action. It has worked closely with the health board and my officials over the past week to ensure appropriate steps are taken at pace. This includes:


* Immediate improvements to medicines prescribing and administration with pharmacy support and daily checking of prescriptions. Further work will be carried out over the next month to develop a standard operating procedure, checklists and audits.
* An audit has been initiated to ensure the timely transfer of babies needing referral to a tertiary unit and reducing inappropriate admissions to the Prince Charles Hospital unit.
* Increasing the intensity of consultants overseeing the unit and increased time allocated to the unit. Closer working with and support from the specialist neonatal unit in Cardiff. The recruitment of an additional two consultant posts is already underway, with one taking up post in November.
* Establishing a specialist centre support programme for neonatal nursing staff.
* Improving specific aspects of clinical practice, including urgent review of the approach to therapeutic cooling of babies and for those requiring intubation.
* Improvements to the standard of documentation, including the introduction of a revised observation chart.


Securing closer working with the Wales maternity and neonatal network and support from neighbouring units, will be key in helping to embed these improvements.


I am mindful of the pressures currently facing staff and neonatal services are no exception \- these findings will be difficult and upsetting. However, the openness of the unit’s staff and their ideas about what needs to change have been welcomed by the panel.


It is important staff are supported to make these improvements and their wellbeing is a key consideration in the health board’s improvement plan. 


Equally, while these findings will be concerning for families using the service, I hope they will see that their voices and involvement really do matter and can effect change. Many of the improvements in train have been informed by their feedback and I am assured that the health board want to work with families to ensure that communication and support is improved and that parents have greater involvement in decisions about their baby’s care.


The panel and my officials will be working closely with the health board to support and monitor the improvements. The panel will be producing a report when this part of their work is concluded and I will make this available to Members when I receive it later this year.


I will continue to keep Members updated and will make a further statement after I receive the next progress report from IMSOP on all aspects of its work and its assessment of the health board’s overall progress.


The panel is finalising its analysis and findings from the second element of the clinical review look back programme, involving babies who sadly were stillborn. I will also make this report available.


This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Senedd returns I would be happy to do so.







Translation:


 
Yn ystod y misoedd diwethaf, mae’r Panel Trosolwg Annibynnol ar Wasanaethau Mamolaeth, a sefydlwyd i oruchwylio gwelliannau mewn gofal mamolaeth a gofal newyddenedigol ym Mwrdd Iechyd Prifysgol Cwm Taf Morgannwg, wedi cryfhau ei ffocws ar ofal newyddenedigol.


Ym mis Mawrth, ymunodd Dr Alan Fenton, neonatolegydd ymgynghorol a Ms Kelly Harvey, nyrs newyddenedigol â’r panel. Ym mis Mai, gyda chymorth tîm bychan o adolygwyr clinigol, dechreuwyd adolygiad manwl o’r gwasanaeth newyddenedigol yn Ysbyty’r Tywysog Siarl ym Merthyr Tudful. Cytunwyd ar y cylch gorchwyl gyda’r bwrdd iechyd a oedd yn croesawu’r datblygiad hwn. Y nod oedd ystyried y gwasanaeth newyddenedigol presennol a’r cynllun gwella sydd ar waith i geisio sicrwydd bod gwasanaethau’n ddiogel, yn effeithiol, yn cael eu harwain yn dda ac, yn hollbwysig, wedi’u hintegreiddio â gofal mamolaeth i ddarparu gwasanaeth di\-dor ar gyfer menywod a’u babanod.


Mae’r ymarfer cynhwysfawr hwn yn cael ei lywio gan dystiolaeth a gasglwyd o amryw o ffynonellau gan gynnwys:


* Adborth gan deuluoedd sydd â phrofiad o ofal newyddenedigol. Ymatebodd mwy na 100 o deuluoedd i ymarfer gwrando a gynhaliwyd gan y panel yn ystod mis Gorffennaf.
* Sgyrsiau gyda staff a rhanddeiliaid ehangach.
* Adolygiadau achos o’r babanod salaf yn yr uned newyddenedigol yn ystod 2020\.
* Adolygiad o ystod eang o ddogfennau’n ymwneud â chanlyniadau clinigol, diogelwch a data effeithiolrwydd yn ogystal â llywodraethu clinigol a sicrwydd.


O’r dystiolaeth a adolygwyd hyd yma, mae’r panel wedi nodi rhai meysydd y mae’n credu sy’n cael effaith ar ddarpariaeth gyson y gofal diogel ac effeithiol y byddem yn ei ddisgwyl gan uned o’r fath yn y DU.


Felly, penderfynodd roi gwybod i’r bwrdd iechyd am ei ganfyddiadau interim ac uwchgyfeirio amryw o faterion i’w gweithredu ar unwaith ac yn y tymor byr. Mae wedi gweithio’n agos gyda’r bwrdd iechyd a’m swyddogion dros yr wythnos ddiwethaf i sicrhau bod camau priodol yn cael eu cymryd yn gyflym. Mae hyn yn cynnwys:


* Gwelliannau ar unwaith i ragnodi a gweinyddu meddyginiaethau gyda chymorth y fferyllfa a gwirio presgripsiynau yn ddyddiol. Gwneir gwaith pellach dros y mis nesaf i ddatblygu gweithdrefn safonol, rhestrau gwirio ac archwiliadau.
* Dechreuwyd archwiliad i sicrhau bod babanod sydd angen eu hatgyfeirio i uned drydyddol yn cael eu trosglwyddo’n brydlon, a lleihau derbyniadau amhriodol i’r uned yn Ysbyty’r Tywysog Siarl.
* Cynyddu nifer y meddygon ymgynghorol sy’n goruchwylio’r uned a chynyddu’r amser sy’n cael ei neilltuo i’r uned. Gweithio’n agosach gyda’r uned newyddenedigol arbenigol yng Nghaerdydd a chael rhagor o gymorth ganddi. Mae’r broses o recriwtio dau feddyg ymgynghorol ychwanegol wedi dechrau, a bydd un yn dechrau yn ei swydd ym mis Tachwedd.
* Sefydlu rhaglen gymorth canolfan arbenigol ar gyfer staff nyrsio newyddenedigol.
* Gwella agweddau penodol o bractis clinigol, gan gynnwys adolygiad brys o ddulliau oeri babanod yn therapiwtig a babanod sydd angen tiwbiau anadlu.
* Gwella safonau dogfennau, gan gynnwys cyflwyno siart arsylwi newydd.


Bydd sicrhau cydweithio agosach gyda rhwydwaith mamolaeth a newyddenedigol Cymru a chymorth gan unedau cyfagos yn allweddol i helpu i roi’r gwelliannau hyn ar waith.


Rwy’n ymwybodol o’r pwysau sy’n wynebu staff ar hyn o bryd, ac nid yw gwasanaethau newyddenedigol yn eithriad – bydd yn anodd iddynt weld y canfyddiadau hyn. Fodd bynnag, mae’r panel wedi croesawu gonestrwydd staff yr uned a’u syniadau am yr hyn sydd angen newid.


Mae’n bwysig bod staff yn cael eu cefnogi i wneud y gwelliannau hyn a bod eu llesiant yn ystyriaeth allweddol yng nghynllun gwella’r bwrdd iechyd. 


Yn yr un modd, er y bydd y canfyddiadau hyn yn peri pryder i deuluoedd sy’n defnyddio’r gwasanaeth, rwy’n gobeithio y byddant yn gweld bod eu llais a’u cyfraniad yn wirioneddol bwysig ac yn arwain at newid. Mae llawer o’r gwelliannau a roddwyd ar waith wedi bod o ganlyniad i’w hadborth a bydd y bwrdd iechyd eisiau gweithio gyda theuluoedd i sicrhau gwell cyfathrebu a chymorth a sicrhau bod rhieni’n cael eu cynnwys mwy mewn penderfyniadau am ofal eu baban.


Bydd y panel a’m swyddogion yn gweithio’n agos gyda’r bwrdd iechyd i gefnogi a monitro’r gwelliannau. Bydd y panel yn llunio adroddiad pan ddaw’r rhan hon o’r gwaith i ben a bydd yr adroddiad ar gael i Aelodau pan fyddaf yn ei gael yn nes ymlaen yn y flwyddyn.


Byddaf yn parhau i roi’r wybodaeth ddiweddaraf i’r Aelodau ac yn gwneud datganiad pellach wedi imi gael yr adroddiad cynnydd nesaf gan y Panel Trosolwg Annibynnol ar Wasanaethau Mamolaeth ar bob agwedd o’i waith a’i asesiad o gynnydd cyffredinol y bwrdd iechyd. Mae’r Panel wrthi’n cwblhau ei ddadansoddiad a’i ganfyddiadau o ail elfen y rhaglen adolygu clinigol, sy’n cynnwys babanod marwanedig. Byddaf hefyd yn sicrhau bod yr adroddiad hwn ar gael.


Mae'r datganiad hwn yn cael ei gyhoeddi yn ystod y toriad er mwyn rhoi'r wybodaeth ddiweddaraf i'r Aelodau. Os bydd yr Aelodau am imi wneud datganiad pellach neu ateb cwestiynau am hyn pan fydd y Senedd yn dychwelyd, byddwn yn falch o wneud hynny.