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The Independent Maternity Services Oversight Panel has continued to provide challenge and support to Cwm Taf Morgannwg University Health Board as it improves maternity and neonatal services.


Today, I am publishing the panel’s September 2022 Progress Report, which summarises its assessment of the progress made by the health board.


In my update to Members on 23 May, I agreed a set of conditions jointly developed between the panel and the health board to support the delivery of continuous and sustainable improvements. These spanned maternity and neonatal services and included advancements in quality improvement initiatives, enhanced medical leadership, further work to address culture change and the delivery of a cross\-service strategy.


The health board has focused on delivering the required improvements within each of the conditions during this reporting period. The panel has maintained oversight of progress and, at the beginning of September, visited the health board to assess whether the changes could be felt on the ground and were generating a positive impact for staff, families and communities using the services.


I am pleased to report the panel’s assessment that each of the conditions have been met during this reporting period and the health board’s maternity and neonatal improvement journey can now be considered sustainable.


This clear progress is testament to the dedication and resilience shown by health board staff at all levels in delivering service improvements within challenging circumstances. It is also important to recognise the resolve demonstrated by families who have and continue to ensure their experiences help shape service design and delivery. I want to thank staff and families for their clear commitment to ensuring maternity and neonatal services meet the expectations of local communities.


It is reassuring to read the panel’s reflections following its assurance visit that the maternity service felt markedly different when compared to the services and conditions it observed in 2019\. I welcome the enthusiasm and confidence demonstrated by staff in taking forward improvement activities, alongside their pride in wishing to provide the best possible care for the families and communities they serve.


Culture change in any organisation takes time and dedication and there will always be more to do. I am encouraged that the health board’s leadership recognises these further development opportunities and remains committed to working collaboratively with staff in taking forward these positive cultural changes.    


In light of the panel’s assessment and that of other key national stakeholders, I am pleased to announce my decision to de\-escalate the health board’s maternity and neonatal services from special measures to targeted intervention. This transition recognises the clear progress made over the last three\-and\-a\-half years.


A degree of oversight and support will continue to be required; this is particularly true for the neonatal service, which still has some way to go in its improvement journey. Under targeted intervention, we will continue to work with the health board to ensure all the necessary improvements are made and embedded in practice.


I expect the health board to maintain the momentum over recent months in delivering the remainder of the neonatal improvement plan in line with proposed timescales.


Alongside my decision to de\-escalate from special measures, I am also standing down the oversight panel at the end of the year. This will provide time to determine arrangements for monitoring and support and ensure any learning from the oversight process is captured and taken forward.


I want to thank the members of the panel for their dedication in supporting the health board to deliver the necessary improvements, the transparent way they have reported on progress and importantly, their commitment to placing the needs and experiences of families at the heart of the oversight process. 


As Members are aware, there are a number of national programmes of work underway which will support a clear understanding of maternity and neonatal service provision across Wales, as well as help to identify any improvements which can be made and provide the support necessary to take these forward collaboratively with health boards.


It is vital that the learning from the panel’s clinical review programme and Cwm Taf Morgannwg’s improvement journey continues to feed into these programmes.







Translation:


 
Mae'r Panel Trosolwg Annibynnol ar Wasanaethau Mamolaeth wedi parhau i ddarparu her a chymorth i Fwrdd Iechyd Prifysgol Cwm Taf Morgannwg wrth iddo wella’i wasanaethau mamolaeth a newyddenedigol.


Heddiw, rwy'n cyhoeddi Adroddiad Cynnydd Medi 2022 y panel, sy'n crynhoi ei asesiad o'r cynnydd a wnaed gan y bwrdd iechyd.


Pan roddais yr wybodaeth ddiweddaraf i'r Aelodau ar 23 Mai, cytunais ar gyfres o amodau a a ddatblygwyd ar y cyd rhwng y panel a'r bwrdd iechyd i gefnogi'r gwaith o wneud gwelliannau parhaus a chynaliadwy. Roedd y rhain yn rhychwantu gwasanaethau mamolaeth a gwasanaethau newyddenedigol ac yn cynnwys datblygiadau o ran mentrau gwella ansawdd, arweinyddiaeth feddygol well, gwaith pellach i fynd i'r afael â newid diwylliant, a gweithredu strategaeth ar draws gwasanaethau.  


Mae'r bwrdd iechyd wedi canolbwyntio ar wneud y gwelliannau angenrheidiol ym mhob un o'r amodau yn ystod y cyfnod adrodd hwn. Mae'r panel wedi cynnal trosolwg o’r cynnydd, a ddechrau mis Medi ymwelodd â'r bwrdd iechyd i farnu a ellid teimlo'r newidiadau yn y fan a’r lle, ac a oeddent yn creu effaith gadarnhaol i’r staff ac i’r teuluoedd a'r cymunedau sy'n defnyddio’r gwasanaethau.


Rwy'n falch o roi gwybod bod y panel o’r farn fod pob un o’r amodau wedi’u bodloni yn ystod y cyfnod adrodd hwn ac y gellir bellach ystyried fod taith gwella gwasanaethau mamolaeth a newyddenedigol y bwrdd iechyd yn un gynaliadwy.


Mae'r cynnydd clir hwn yn dangos ymroddiad a gwydnwch staff y bwrdd iechyd ar bob lefel wrth iddynt sicrhau gwelliannau i wasanaethau o dan amgylchiadau heriol. Mae hefyd yn bwysig cydnabod ymroddiad y teuluoedd sydd wedi sicrhau bod eu profiadau'n helpu i lywio'r gwaith o gynllunio a darparu gwasanaethau ac sy'n parhau i wneud hynny. Hoffwn ddiolch i’r staff a’r teuluoedd am eu hymrwymiad clir i sicrhau bod y gwasanaethau mamolaeth a newyddenedigol yn bodloni disgwyliadau'r cymunedau lleol.  


Mae'n galonogol darllen sylwadau’r panel, yn dilyn ei ymweliad sicrwydd, sy’n nodi bod y gwasanaeth mamolaeth yn teimlo'n wahanol iawn i’r gwasanaethau a’r amodau a welwyd yn 2019\. Rwy'n croesawu brwdfrydedd a hyder y staff wrth iddynt fwrw ymlaen â'r gweithgareddau gwella, ochr yn ochr â'u balchder o geisio darparu'r gofal gorau posibl i'r teuluoedd a'r cymunedau y maent yn eu gwasanaethu.


Mae’n cymryd amser i newid diwylliant unrhyw sefydliad a bydd bob amser fwy i’w wneud. Mae’n galonogol bod arweinwyr y bwrdd iechyd yn cydnabod y cyfleoedd ychwanegol hyn i ddatblygu a’u bod yn parhau i fod yn ymrwymedig i weithio ar y cyd â’r staff i fwrw ymlaen â’r newidiadau diwylliannol cadarnhaol hyn.    


Yn sgil asesiad y panel a rhanddeiliaid cenedlaethol allweddol eraill, rwy'n falch o gyhoeddi fy mhenderfyniad i symud  gwasanaethau mamolaeth a newyddenedigol y bwrdd iechyd o fesurau arbennig i ymyrraeth wedi’i thargedu. Mae'r newid hwn yn cydnabod y cynnydd clir a wnaed dros y tair blynedd a hanner diwethaf.


Bydd angen rhywfaint o oruchwyliaeth a chefnogaeth o hyd. Mae hyn yn arbennig o wir am y gwasanaeth newyddenedigol, sydd â pheth ffordd i fynd yn ei daith wella o hyd. O dan ymyrraeth wedi'i thargedu, byddwn yn parhau i weithio gyda'r bwrdd iechyd i sicrhau bod yr holl welliannau angenrheidiol yn cael eu gwneud ac yn cael eu gwreiddio'n ymarferol.


Rwy'n disgwyl i'r bwrdd iechyd gynnal y momentwm sydd wedi'i greu yn ystod y misoedd diwethaf wrth iddo gyflawni gweddill y cynllun gwella gwasanaethau newyddenedigol yn unol â'r amserlenni arfaethedig.


Ochr yn ochr â’m penderfyniad i godi’r mesurau arbennig, rwyf hefyd yn dod â’r panel goruchwylio i ben ddiwedd y flwyddyn. Bydd hyn yn rhoi amser i bennu trefniadau ar gyfer monitro a chefnogi, ac i sicrhau bod unrhyw wersi o'r broses oruchwylio yn cael eu cofnodi a’u datblygu.


Hoffwn ddiolch i aelodau'r panel am eu hymroddiad i helpu’r bwrdd iechyd i gyflawni'r gwelliannau angenrheidiol, am y ffordd dryloyw y maent wedi'i adrodd ar y cynnydd ac, yn bwysig iawn, eu hymrwymiad i osod anghenion a phrofiadau teuluoedd wrth wraidd y broses oruchwylio. 


Fel y mae'r Aelodau’n gwybod, mae nifer o raglenni gwaith cenedlaethol ar y gweill a fydd yn helpu i roi dealltwriaeth glir o'r ddarpariaeth o ran gwasanaethau mamolaeth a newyddenedigol ledled Cymru. Byddant hefyd yn helpu i nodi unrhyw welliannau y gellir eu gwneud ac yn darparu'r gefnogaeth sy'n angenrheidiol i fwrw ymlaen â'r rhain ar y cyd â'r byrddau iechyd.


Mae'n hanfodol bod yr hyn a ddysgwyd o raglen adolygu clinigol y panel a thaith wella Cwm Taf Morgannwg yn parhau i fwydo'r rhaglenni hyn.