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Aelodau’r Cynulliad, mae’n bleser gennyf rannau gyda chi dystiolaeth wirioneddol o’r gwelliannau mewn gofal canser sy’n digwydd yma yng Nghymru. Hoffwn gymryd y cyfle hwn i rannu’r newyddion da gyda chi, yn ogystal ag egluro sut rwyf yn bwriadu adeiladu ar hyn yn y misoedd sy’n dod i sicrhau fod y gofal canser a gynigir yng Nghymru yn parhau i wneud gwelliannau pendant.

Mae canser yn fwy nag “amseroedd aros”, mae’n ymwneud â phobl, am eu gofal ac yn ein Harolwg diweddar o Brofiad Cleifion Canser, roeddwn yn falch o weld fod cynifer o bobl yn canmol eu gofal.

Roedd canlyniadau’r Arolwg o Brofiad Cleifion Canser yng Nghymru, a drefnwyd mewn partneriaeth â Chymorth Canser Macmillan, ac a gyhoeddwyd ar 27 Ionawr yn gofyn i bobl oedd wedi cael diagnosis o ganser i roi adborth ar y gofal a’r driniaeth a gawsant. Drwyddi draw, roedd y gofal a gafodd cleifion canser yng Nghymru naill ai yn ‘rhagorol’ neu’n ‘dda iawn’ yn ôl yr 89 y cant o gleifion a ymatebodd. Cododd y ffigwr hwnnw i 97 y cant o gleifion a oedd yn credu fod eu gofal yn ‘dda’. Mae’n galonogol gweld fod cynifer o gleifion wedi cael profiad cadarnhaol o’u gofal canser ac mae’r dystiolaeth fod systemau effeithiol yn eu lle ochr yn ochr â chymorth i unigolion yn amlwg iawn.

Roedd yr arolwg yn adrodd barn 7,352 o gleifion canser. Gyda chyfradd ymateb o 69%, mae’r canlyniadau’n cynnig dadansoddiad cadarn a chynhwysfawr o brofiadau pobl o ganser. Neges glir yr arolwg hwn yw bod mwyafrif y bobl yn derbyn gofal a chymorth ardderchog mewn ystod eang o feysydd.

Nid oedd yr arolwg yn canolbwyntio ar feddyginiaeth a gweithredoedd meddygol yn unig. Roedd yn ystyried y siwrne gyfan y mae rhywun yn ei hwynebu, gan ddechrau o’r diagnosis cyntaf o ganser. Mae’n falch gen i adrodd fod 85% o bobl yn dweud eu bod bob amser yn cael eu trin â pharch ac urddas gan staff; roedd gan 87% ffydd ac ymddiriedaeth yn y meddygon a’r nyrsys oedd yn gofalu amdanynt a dywedodd 94% eu bod yn cael digon o breifatrwydd wrth gael eu trin.

Mae’n bwysig hefyd fod yr arolwg wedi tynnu sylw at elfennau gofal sydd angen eu gwella. Mae yna amrywiad rhwng safleoedd ysbyty a rhai mathau o ganser ac mae angen gwneud ymdrech i leihau’r amrywiad hwn. Er enghraifft roedd y rheiny â chanser y fron yn fwy cadarnhaol eu hymatebion na’r rheiny â sarcoma neu ganser yr ysgyfaint neu wrolegol. Er bod dwy ran o dair o’r cleifion wedi cael enw gweithiwr allweddol, ac yn adrodd am fanteision cael gweithwyr allweddol a nyrsys canser arbenigol, mae’n amlwg fod angen mwy o waith i wella cysondeb mynediad. Mae gwaith yn mynd rhagddo gyda’r rhwydweithiau canser yng Nghymru ynghylch pa ddyletswyddau y dylai arbenigwyr nyrsio clinigol eu darparu. Er bod 68% o gleifion yn dweud eu bod wedi trafod neu wedi cael gwybodaeth am effaith canser ar waith neu addysg, dim ond 51% a ddywedodd eu bod wedi cael gwybodaeth am sut i gael cymorth neu fudd\-daliadau ariannol gan staff yr ysbyty. Bydd angen gwneud mwy i fodloni anghenion holistig y claf.

Dyma’r flwyddyn gyntaf i’r arolwg hwn gael ei gynnal yng Nghymru a bydd angen i’r GIG yn gyffredinol wrando ar leisiau’r cleifion a gweithredu arnynt. Mae’r arolwg hwn yn ein helpu i gasglu’r math cywir o dystiolaeth fel y gallwn ddeall yn well anghenion gwahanol y bobl sy’n defnyddio’n gwasanaethau. Mae’n cynnig darlun pwysig i ni o’r hyn sy’n bwysig i unigolion, nid dim ond amseroedd aros. Gyda’r dystiolaeth a roesant i ni, gallwn barhau i wella’n gwasanaethau a sicrhau profiadau cleifion, yn awr ac yn y dyfodol.

Ar 31 Ionawr, fe gyhoeddasom ein hail Adroddiad Canser Blynyddol. Roeddwn yn falch iawn o ddarllen mai yng Nghymru y mae’r cynnydd mwyaf mewn cyfraddau goroesi canser yn y DU. Mae’r adroddiad hwn yn dangos gwelliannau gwirioneddol mewn gofal canser yng Nghymru yn ystod y flwyddyn ddiwethaf. Mae hyn yn deyrnged i bawb sy’n ymwneud â chynllunio a darparu’r gofal.

Tynnir sylw hefyd yn yr adroddiad at y llwyddiant o ran y cynnydd yn nifer y bobl sy’n cael y brechlyn Feirws Paipiloma Dynol (HPV), o 85\.5% yn 2011/12 i 86\.6% yn 2012/13\. Mae’r brechiad hwn yn atal canser serfigol, sef yr ail ganser mwyaf cyffredin ymhlith menywod dan 35 oed.

Mae’r adroddiad hefyd yn tynnu sylw at y meysydd y dylid canolbwyntio arnynt yn y flwyddyn i ddod. Mae’r rhain yn cynnwys gwrthdroi’r dirywiad yn nifer y bobl sy’n mynd i gael eu sgrinio am ganser y coluddyn. Ac er bod yr adroddiad yn dweud wrthym ein bod yn gyson wedi cyrraedd y targed 31 diwrnod ers mis Gorffennaf 2013, ein nod yw adeiladu ar welliannau diweddar yn erbyn y targed 62 diwrnod i’r rhai sydd newydd gael diagnosis o ganser.

Er mai’r gwelliant yn ein cyfraddau goroesi canser yw’r gorau yn y DU, rydym eto i gyrraedd y lefelau sydd mewn nifer o wledydd eraill yn Ewrop, felly mae angen inni barhau i wneud cynnydd.

Mae’n bwysig nad ydym yn beirniadu gwasanaethau ar amseroedd mynediad yn unig. Yn yr arolwg mewn ymateb i’r cwestiwn am aros cyn mynd i’r ysbyty, dywedodd 78% eu bod wedi cael eu gweld cyn gynted ag y teimlent fod angen. Mae’r Cynllun Cyflawni ar gyfer Canser yn ein galluogi i edrych ar amryw o fesurau sy’n effeithio ar ganlyniadau cyfraddau goroesi yn gyffredinol.

Mae’r oncolegwyr mwyaf blaenllaw yng Nghymru yn parhau i ddweud wrthyf nad yw’r gwahaniaeth rhwng achosion 31 a 62 diwrnod yn un sy’n adlewyrchu’r safonau uwch o ofal cleifion sy’n bodoli heddiw.

Rwyf newydd dderbyn cyngor gan uwch glinigwyr ynglŷn â thargedau mynediad i wasanaethau canser. Roedden nhw’n argymell datblygu un llwybr i’r claf gydag amseroedd aros yn cael eu hadrodd o’r atgyfeiriad gan y Meddyg Teulu neu o’r diagnosis, yn dibynnu ar y llwybr i ddiagnosis. Byddai hyn yn arwain at symud i ffwrdd o ddefnyddio adroddiadau unigol fel prif ddisgrifydd ansawdd y gofal a dderbynnir gan y mwyafrif o gleifion canser tuag at system sy’n cynrychioli’r boblogaeth gyfan yn well a chymhlethdod cynyddol gofal canser. Gofynnais am gael symud tuag at dreialu’r system hon yn weddol gyflym.

Byddaf yn gwerthuso canlyniadau’r cynllun peilot ac os argymhellir newidiadau yn syth, byddaf yn rhoi ystyriaeth fuan iddynt. Bydd y gwaith ehangach yn mynd yn ei flaen drwy ymgysylltiad clinigol rhwng nawr a mis Ebrill 2014\.

Mae pob claf yn haeddu’r gofal gorau. Er bod canlyniadau’r Adroddiad Blynyddol a’r adroddiad arolwg cleifion yn dangos ein bod yn symud i’r cyfeiriad cywir, byddwn yn dal ati i wneud gwelliannau ymhob agwedd ar ofal a thriniaeth canser.

Rwyf yn sicr, fod y polisïau a’r broses yr ydym ni a’r byrddau iechyd wedi gweithio’n galed i’w datblygu i gefnogi gofal canser, bellach yn cael effaith go iawn ar ofal canser ac rwyf yn benderfynol o sicrhau fod y gwelliannau hyn yn parhau.  








Translation:


 
Assembly Members, I am really pleased to share with you real evidence of the improvements in cancer care that are being made here in Wales. I would like to take this opportunity to share this good news with you, as well as how I intend to build upon this in the coming months to ensure that cancer care offered in Wales continues to make sustained improvements.


Cancer is about more than “waiting times”. It is about people and their care.  In our recent Cancer Patient Experience Survey, I was pleased to see that so many people rate their care highly.


The results of the Cancer Patient Experience Survey, run in partnership with Macmillan Cancer Support, and published on the 27 January asked people diagnosed with cancer to provide feedback on the care and treatment they received. Overall, the care received by cancer patients in Wales was either ‘excellent’ or ‘very good’ according to 89 per cent of patients who responded. That figure rose to 97 per cent of patients who thought their care was ‘good’. It is encouraging to see that so many patients had a positive experience of their cancer care and the evidence of effective systems being in place alongside support to individuals is very clear


The survey reported the views of 7,352 cancer patients. With a 69% response rate the results provide a robust and comprehensive analysis of people’s experiences of cancer. The clear message of this survey is the majority of people receive excellent care and support in a wide range of areas.  


The survey did not just concentrate on medication and surgical procedures. It considered the whole journey faced by a person, starting when they are first given a diagnosis of cancer. I am pleased to report that 85% of people said they were always treated with respect and dignity by staff; 87% had confidence and trust in the doctors and nurses caring for them and 94% said they had enough privacy when being treated.


Importantly, the survey has also highlighted areas of care which need improvement. Variation does exist between hospital sites and some cancer types and effort is needed to drive down this variation. For example those with breast cancer were more positive in their responses than those with sarcoma, lung or urological cancers. While two thirds of patients were given the name of a key worker, and report the benefit of having key workers and cancer nurse specialists, it is clear that more work is needed to improve consistency of access. There is ongoing work with the cancer networks in Wales about what duties clinical nurse specialists should provide.  Whilst 68% of patients said they had discussed or been given information about the impact of cancer on work or education, only 51% said they had been given information about how to get financial help or benefits by hospital staff. More action will be taken to meet the holistic needs of the patient.


This is the first year this survey has taken place in Wales and the NHS as a whole will need to listen to and act upon the voices of patients. This survey helps us in gathering the right kind of evidence so we can better understand the different needs of people who use our services. It provides us with an important picture of what matters to individuals, not simply the currency of time. With the evidence they have given to us, we can continue to improve our services and ensure the experiences of patients, both present and future.


On the 31 January, we published our second Cancer Annual Report. I was very pleased to learn that Wales has the biggest increase in cancer survival rates in the UK. The report demonstrates real improvements in cancer care in Wales over the past year and this is a tribute to all those involved in the planning and delivery of care.


Another area of success highlighted by the report is in the increase in the uptake of the HPV vaccine, from 85\.5% in 2011/12 to 86\.6% in 2012/13\. This vaccine prevents cervical cancer, which is the second most common cancer in women under the age of 35\.


The report also highlights a number of areas where we need to focus efforts in the coming year.  This includes reversing the decline in the numbers of people taking up bowel cancer screening. And while the report tells us we have consistently achieved the 31 day target since July 2013 on a monthly basis, we aim to build on recent improvements against the 62\-day target for those newly diagnosed with cancer.


While our cancer survival improvement has been the best in the UK, we are still to reach the levels achieved in a number of other European countries. We need to continue to make progress here.


It is important we don’t judge services on access times alone. In the survey in response to the question about waits for hospital 78% said they felt that they were seen as soon as they thought was necessary. The Cancer Delivery Plan allows us to look at a variety of measures which impact on overall outcome survival rates.


I continue to be advised by the most senior oncologists in Wales that the distinction between 31 and 62 day cases is not one which reflects today’s highest standards of patient care.


I have recently received advice from senior clinicians concerning targets for access to cancer services. They recommended the development of a single patient pathway with waiting times reported from GP referral or from diagnosis depending on the route to diagnosis. This would result in a move away from using individual breech reports as a primary descriptor of the quality of care received by the majority of cancer patients towards s system that is  more representative of the whole population and  the increasing complexity of cancer care. I have asked that we pilot this system relatively quickly. I will evaluate the results of the pilot and if there are immediate changes recommended, I will action them rapidly. Wider work will proceed through clinical engagement on the development of the pilots between now and April 2014\.


Every patient deserves the best care. Whilst the results of both the Annual Report and the patient survey report indicate we are taking steps in the right direction, we will continue to work to make improvements in all aspects of cancer care and treatment.


I am clear, that the policies and process we and the health boards have worked hard to develop in support of cancer care is now having a real impact upon cancer care.  I am determined to ensure that these improvements continue.