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In April 2011, the Welsh Government introduced Putting Things Right – the new arrangements for the management of concerns and complaints in the NHS. This aimed to make it easier for patients, relatives and carers to raise concerns; to be engaged and supported during the process; to be dealt with openly and honestly and for organisations to learn from concerns.


Almost three years on from the introduction of Putting Things Right, in February 2014, I commissioned a review of the way in which the NHS in Wales responds to concerns and complaints to consider how effectively these arrangements are working.


The  review was led by Keith Evans, the former chief executive and managing director of Panasonic UK and Ireland.


I would like to thank Mr Evans for his comprehensive report and the significant public and stakeholder engagement which has taken place as part of the review process. This is a subject on which people hold strong views and Mr Evans has reflected those in his report.  


He is to be commended for the thoroughness of his engagement and for being able to reach and engage with such a breadth and diversity of people in such a short period of time.  The Report takes full account of other relevant work in this field, including the review of the NHS complaints system in England carried out by Ann Clwyd, MP, ensuring that the issues Welsh patients raised in her review have been addressed in this review.  It also takes into account  the findings of the recent Trusted to Care Report which, independently, highlighted concerns about the NHS complaints process.


Among the many personal observations he makes in his report, I was particularly struck by Mr Evans’ comments about how difficult it can be for staff working in the NHS when they feel constantly under “siege” . The  report illustrates the impact this has upon them and their ability to do the jobs which are so important to us all.  


We know the vast majority of patients are happy with the overall care they receive but when things go wrong the right mechanisms need to be in place to address concerns. As Mr Evans points out, with the very large number of patients whom the NHS treats each and every day,  if even a very small fraction have concerns about their care this can amount to thousands of people.


As part of his review, I asked Mr Evans to suggest improvements, which could be made to Putting Things Right. He has made a large number of key recommendations.


However, his overall message is that Putting Things Right is the right approach for managing complaints and concerns, although there are variations in the way it is implemented across Wales. This needs to be addressed. His review finds Putting Things Right has been successful in generating complaints but it has not had the accompanying infrastructure to keep pace with this. There are also suggestions about how the process should be refined to keep it simple, standard, slim and speedy and, above all, easy for patients and relatives to access and navigate.  


The NHS needs to be open and honest and accept feedback from patients and staff as a “gift” which should be embraced and acted upon. The report indicates some organisations may not always be – or be perceived to be – open, which can lead to needless and repetitive complaints. This needs to change. Staff must also be empowered to deal quickly with concerns and at source.  He makes it clear that staff need to have the necessary training and support to deal with complaints effectively.


The key for everyone, whatever their particular job, Mr Evans says, is to put themselves in the shoes of the patient – to see the experience through their eyes, and to respond accordingly.


The NHS must carefully consider Mr Evans’ review and his recommendations. While there are some immediate actions for health boards, NHS trusts and partner organisations to take forward, I want  them and the public to have the opportunity to consider the review and its recommendations and put forward their views. 


For example, Mr Evans suggests that a more national approach towards complaints and concerns should be considered to ensure greater consistency. He puts forward a number of ways about how this could be taken forward. I am particularly interested to hear views on some of these more wide\-reaching recommendations.


Following a period of wider engagement over the summer, I will make a further statement in the autumn.


 


 







Translation:


 
Ym mis Ebrill 2011, cyflwynodd Llywodraeth Cymru Gweithio i Wella  \- y trefniadau newydd ar gyfer rheoli pryderon a chwynion yn y GIG. Y nod oedd ei gwneud yn haws i gleifion, perthnasau a gofalwyr godi pryderon; bod yn rhan o'r broses a chael cymorth yn hynny o beth; cael eu trin yn agored ac yn onest ac i sefydliadau ddysgu o bryderon.

Bron dair blynedd ar ôl cyflwyno Gweithio i Wella, ym mis Chwefror 2014, comisiynwyd adolygiad gennyf o'r ffordd y mae'r GIG yng Nghymru yn ymateb i bryderon a chwynion i ystyried pa mor effeithiol y mae'r trefniadau hyn yn gweithio.

Arweiniwyd yr adolygiad gan Keith Evans, cyn brif weithredwr a rheolwr gyfarwyddwr Panasonic y DU ac Iwerddon.

Hoffwn ddiolch i Mr Evans am ei adroddiad cynhwysfawr ac am ymgysylltu'n helaeth â'r cyhoedd a rhanddeiliaid fel rhan o'r broses adolygu. Mae'n amlwg bod gan bobl farn gref am y pwnc hwn ac mae Mr Evans wedi adlewyrchu'r farn honno yn ei adroddiad.  

Dylid ei ganmol am ei brosesau ymgysylltu trylwyr ac am lwyddo i gyrraedd  nifer mor eang ac amrywiol o bobl ac ymgysylltu â hwy mewn cyfnod mor fyr.  Mae'r Adroddiad yn rhoi ystyriaeth lawn i waith perthnasol arall yn y maes hwn, gan gynnwys yr adolygiad o system gwyno y GIG yn Lloegr a gynhaliwyd gan Ann Clwyd, AS, gan sicrhau bod y materion a godwyd gan gleifion o Gymru yn ei hadolygiad wedi cael sylw yn yr adolygiad hwn.  Mae hefyd yn ystyried canfyddiadau'r Adroddiad Ymddiried mewn Gofal a gyhoeddwyd yn ddiweddar ac a amlygodd, yn annibynnol, bryderon am broses gwyno'r GIG.

Ymhlith y nifer o sylwadau personol a wna yn ei adroddiad, fe'm trawyd yn arbennig gan sylwadau Mr Evans ynghylch pa mor anodd y gall y sefyllfa fod i staff sy'n gweithio yn y GIG pan fyddant yn teimlo eu bod dan "warchae" yn gyson. Dengys yr adroddiad yr effaith a gaiff hyn arnynt ac ar eu gallu i wneud y gwaith sydd mor bwysig i bob un ohonom.  

Gwyddom fod y rhan fwyaf o gleifion yn fodlon ar y gofal cyffredinol a gânt ond pan fydd pethau'n mynd o chwith mae'n rhaid i'r mecanweithiau cywir fod ar waith i ymdrin ag unrhyw bryderon. Fel y noda Mr Evans, o gofio'r nifer sylweddol iawn o gleifion y mae'r GIG yn eu trin bob dydd, hyd yn oed os oes gan gyfran fach iawn ohonynt bryderon am eu gofal, gall hyn fod yn gyfystyr â miloedd o bobl.

Fel rhan o'i adolygiad, gofynnais i Mr Evans awgrymu gwelliannau i Gweithio i Wella. Mae wedi gwneud nifer fawr o argymhellion allweddol.

Fodd bynnag, ei neges gyffredinol yw mai Gweithio i Wella yw'r dull cywir ar gyfer rheoli cwynion a phryderon, ond mae amrywiadau yn y ffordd y caiff ei roi ar waith ledled Cymru. Mae angen mynd i'r afael â hyn. Awgryma ei adolygiad fod Gweithio i Wella wedi bod yn llwyddiannus o ran cynhyrchu cwynion ond nad oedd seilwaith i gyd\-fynd â hyn. Ceir awgrymiadau hefyd ynghylch sut y dylai'r broses gael ei symleiddio er mwyn ei chadw'n syml, yn safonol, yn gryno ac yn gyflym ac, yn anad dim, yn hawdd i'r claf gael mynediad iddi a'i defnyddio.  

Mae angen i'r GIG fod yn agored ac yn onest a derbyn adborth gan gleifion a staff fel "rhodd" i’w chroesawu ac i weithredu arni. Noda'r adroddiad nad yw rhai sefydliadau yn agored bob tro \- neu'n cael eu gweld fel eu bod yn agored \- a gall hyn arwain at gwynion diangen ac ailadroddus. Mae angen i hyn newid. Rhaid i staff hefyd gael eu grymuso i ymdrin yn gyflym â phryderon yn eu tarddiad.  Mae'n ei gwneud yn glir bod angen i staff gael yr hyfforddiant a'r cymorth angenrheidiol i ymdrin â chwynion yn effeithiol.

Dywed Mr Evans mai'r allwedd i bawb, beth bynnag eu swydd, yw rhoi eu hunain yn esgidiau'r claf \- i weld y profiad drwy eu llygaid nhw, ac ymateb yn unol â hynny.

Rhaid i'r GIG ystyried adolygiad ac argymhellion Mr Evans yn ofalus. Er bod rhai camau gweithredu y mae angen i fyrddau iechyd, ymddiriedolaethau'r GIG a sefydliadau partner eu cymryd ar unwaith, rwyf am iddyn nhw a'r cyhoedd gael y cyfle i ystyried yr adolygiad a'i argymhellion a mynegi eu barn. 

Er enghraifft, awgryma Mr Evans y dylid ystyried dull mwy cenedlaethol o ymdrin â chwynion a phryderon er mwyn sicrhau mwy o gysondeb. Awgryma nifer o ffyrdd i symud hyn yn ei flaen. Rwy'n awyddus iawn i glywed barn am rai o'r argymhellion mwy pellgyrhaeddol hyn.

Ar ôl cyfnod o ymgysylltu ehangach dros yr haf, byddaf yn gwneud datganiad arall yn yr hydref.