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Heddiw, mae’n flwyddyn ers imi gyhoeddi’r adroddiad a wnaed ar y cyd gan Goleg Brenhinol yr Obstetryddion a’r Gynaecolegwyr a Choleg Brenhinol y Bydwragedd, yn sgil eu hadolygiad o wasanaethau mamolaeth ym Mwrdd Iechyd Prifysgol Cwm Taf gynt.


Yn ystod y 12 mis diwethaf, mae’r Panel Trosolwg Annibynnol ar Wasanaethau Mamolaeth wedi bod yn monitro a chefnogi’r bwrdd iechyd drwy herio a chraffu fel y bo angen i sicrhau bod gwelliannau’n cael eu gwneud mewn modd agored a thryloyw.


Er gwaethaf y cyfnod digynsail yr ydym yn mynd drwyddo ar hyn o bryd, roeddwn yn awyddus i sicrhau’r menywod a’r teuluoedd, y mae adolygiad y Colegau Brenhinol yn effeithio arnynt, nad ydynt wedi cael eu hanghofio. Er y bu’n rhaid i’r Panel addasu ei arferion gweithio oherwydd yr argyfwng COVID\-19, mae ei waith yn parhau. Wrth i’r gwaith adolygu clinigol symud yn ei flaen, bydd yr hyn a ddysgir o’r gwaith hwnnw’n dylanwadu ar sut y darperir gofal mamolaeth ym Mwrdd Iechyd Prifysgol Cwm Taf Morgannwg.


Heddiw, rwy’n cyhoeddi Adroddiad Cynnydd Chwarterol y Gwanwyn sydd wedi ei baratoi gan y Panel. Dyma’r trydydd diweddariad ganddo, ac mae’r adroddiad hwn yn cynnwys tystiolaeth bellach o’r gwaith gwella parhaus sy’n digwydd o fewn y bwrdd iechyd. Ceir sicrwydd o glywed bod y Panel wedi asesu rhagor o welliannau cynyddrannol sydd wedi eu cyflawni yn ystod y tri mis diwethaf, a’i fod yn credu bod y bwrdd iechyd nawr ar ei ffordd i gyflawni yn erbyn pob un o argymhellion y Colegau Brenhinol.


Rhaid canmol y bwrdd iechyd a’r Panel am y ffaith bod sylw wedi cael ei roi i ychydig dros hanner yr argymhellion, a bod yr argymhellion hyn yn cael eu hymgorffori mewn arferion gweithredol. Ers dechrau’r broses hon, rwyf wedi pwysleisio ei fod yn hanfodol bod yn drylwyr wrth gyflawni’r gwaith, yn hytrach na’i wneud ar frys, er mwyn sicrhau bod unrhyw newidiadau’n gynaliadwy.


Mae’r Panel wedi nodi ei ddisgwyliadau ar gyfer y meysydd y mae angen rhoi sylw penodol iddynt yn ystod y misoedd nesaf. Maent yn cynnwys datblygu ymhellach y Cynllun Gwella Mamolaeth a’r Fframwaith Integredig ar gyfer Asesu Perfformiad a Sicrwydd, gan roi mwy o ffocws ar wasanaethau newyddenedigol. Mae’n hanfodol nad yw’r bwrdd iechyd yn colli golwg ar y meysydd hyn yn ystod y misoedd nesaf, er fy mod yn deall yn iawn y bydd unrhyw gynnydd yn arafach o dan yr amgylchiadau presennol.


O ran y gwaith adolygu clinigol, mae’n dda clywed bod chwe thîm clinigol annibynnol bellach wrthi’n cynnal adolygiadau, a bod y broses sicrwydd ansawdd wedi ei sefydlu. Fel yr eglurais yn fy natganiad diwethaf, bydd cam cyntaf yr adolygiadau clinigol yn canolbwyntio ar yr ofal a ddarparwyd i famau a babanod rhwng 1 Ionawr 2016 a 30 Medi 2018\. Mae Cyngor Iechyd Cymuned Cwm Taf Morgannwg yn parhau i ddarparu cymorth eirioli i’r menywod a’r teuluoedd y mae’r gofal a roddwyd iddynt yn cael ei adolygu, a hoffwn ddiolch i’r menywod a’r teuluoedd hynny sydd eisoes wedi rhannu eu profiadau. Mae’n hanfodol bod eu lleisiau’n parhau’r ganolog i’r adolygiadau clinigol a’r gwaith gwella ehangach.


Rwy’n deall bod y Panel wedi diweddaru ei Strategaeth ar gyfer Adolygiadau Clinigol  er mwyn ystyried yr hyn a ddysgwyd o’r rhaglen hyd yn hyn, gan gynnwys o adborth a chasgliadau’r ymarfer peilot a gwblhawyd ddechrau’r flwyddyn hon. Rwy’n edrych ymlaen at gael rhagor o ddiweddariadau am y gwaith hwn maes o law.


Oherwydd y cynnydd sy’n cael ei wneud o fewn y gwasanaethau mamolaeth, mae’r Panel wedi cynnig y dylid ymestyn y cylch adrodd i chwe mis. Rwyf wedi derbyn yr argymhelliad hwn, a gallaf gadarnhau y byddaf yn cyhoeddi ei adroddiad nesaf ddiwedd Medi 2020\. Wrth gwrs, byddaf yn sicrhau bod Gweinidogion yn cael yr wybodaeth ddiweddaraf fel y bo angen os bydd unrhyw beth pellach, y dylid rhoi gwybod amdano, yn codi cyn hynny.


Mae’n bwysig nodi bod yr hyn a ddysgwyd o’r gwasanaethau mamolaeth hefyd yn cael ei ddefnyddio fel sail i’r gwelliannau sefydliadol ehangach y mae angen eu cyflawni yn dilyn uwchgyfeirio’r sefydliad i lefel ymyriad wedi’i dargedu. Roeddem wedi gwneud penderfyniad blaenorol bod yn rhaid gwella mewn tri maes allweddol: ansawdd a llywodraethu; arweinyddiaeth a diwylliant; ac ail\-adeiladu ymddiriedaeth a hyder. Mae hynny’n gydnaws â’r argymhellion a wnaed gan Arolygiaeth Gofal Iechyd Cymru a Swyddfa Archwilio Cymru yn sgil eu hadolygiad ar y cyd o drefniadau llywodraethu ansawdd y bwrdd iechyd. Fel gyda’r gwasanaethau mamolaeth, cytunwyd ar ddull gweithredu’n seiliedig ar fatrics aeddfedrwydd i dracio gwelliannau a darparu tystiolaeth ohonynt. Roedd nifer o gamau eisoes yn cael eu cymryd, gan gynnwys cyflwyno fframwaith gwerthoedd ac ymddygiadau newydd a model gweithredu newydd. Er gwaethaf y cynnydd cynnar a wnaed mewn llawer o feysydd, yn amlwg mae wedi bod yn hanfodol i’r bwrdd iechyd ganolbwyntio ei ymdrechion ar ymdopi ag effeithiau’r pandemig COVID\-19 yn ystod yr wythnosau diwethaf. Fodd bynnag, er y gallai hynny arafu ychydig ar y gwaith o weithredu’r newidiadau, rwy’n hyderus bod y Bwrdd wedi ymrwymo i wneud popeth o fewn ei allu i sicrhau ei fod yn sefydliad sy’n cael ei yrru gan yr angen i sicrhau ansawdd. Dyma’r unig ganlyniad a fyddai’n dderbyniol i mi.







Translation:


 
Today marks one year since I published the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives joint report, following their review of maternity services at the former Cwm Taf University Health Board.


Over the last 12 months the Independent Maternity Services Oversight Panel has been monitoring and supporting the health board with the necessary challenge and scrutiny to ensure that improvements are being made in an open and transparent manner.


Despite the unprecedented times that we find ourselves in, I want to assure women and families affected by the Royal Colleges’ review that they have not been forgotten. The work of the Panel continues, although their working practice has clearly had to adjust in the context of the COVID\-19 outbreak. Nevertheless, the clinical review work is still very much ongoing. The learning from this work will continue to influence how maternity care is provided in Cwm Taf Morgannwg University Health Board.


Today I am publishing the Panel’s Spring Quarterly Progress Report. This is the third update from the Panel and provides further evidence of the ongoing improvement work within the health board. It is reassuring to hear that the Panel have assessed that further incremental progress has been made during the last three months and that they believe that the health board is firmly on track to deliver against all of the Royal Colleges’ recommendations.


It is a credit to both the health board and the Panel that just over half of the recommendations have been addressed and are being embedded in operational practice. I have emphasised since the start of this process that it is vital the work is completed thoroughly instead of quickly so that sustainable changes are made.


The Panel has set out its expectations for the areas needing particular attention over the next few months. This includes further development of the Maternity Improvement Plan and Integrated Performance Assessment and Assurance Framework with an increased focus on neonatal services. It is essential the health board does not lose sight of these areas over the coming months although I fully appreciate that progress will be on a slower trajectory given the current circumstances.


In terms of the clinical review work, it is positive to hear that there are now six independent clinical teams undertaking reviews and the quality assurance process has been established. As I explained in my last statement, the first phase of clinical reviews will focus on the care of mothers and babies between 01 January 2016 and 30 September 2018\. Advocacy support through the Cwm Taf Morgannwg Community Health Council remains available for women and families whose care is being reviewed. I want to thank the women and families who have come forward already to share their story. It is vital their voices remain at the centre of the clinical reviews and the wider improvement work.


I understand the Panel has updated its Clinical Review Strategy to take account of the learning from the programme to date, including feedback and findings from the pilot exercise that was completed at the start of this year. I look forward to receiving further updates on this work in due course.


The Panel has proposed that in view of the progress which is being made within maternity services that the reporting cycle be extended to six months. I have accepted this recommendation and can confirm that I will be publishing their next report at the end of September 2020\. I will of course update Members should there be anything further to report prior to this.


Importantly, the learning from maternity is also informing the wider organisational improvement needed following the organisation’s escalation to targeted intervention. We had previously determined that improvement was required in three key areas: quality and governance; leadership and culture; and rebuilding trust and confidence. This aligns with the recommendations from the Healthcare Inspectorate Wales and Wales Audit Office joint review of the health board’s quality governance arrangements. As with maternity, a maturity matrix approach has been agreed to track and evidence improvement. A number of actions were already well in train including the introduction of a new values and behaviours framework and the new operating model. Despite early progress being made in many areas, it has clearly been essential for the health board to focus its efforts on preparing and managing the impact of the COVID\-19 outbreak in recent weeks. However, whilst this may impact on the pace of change I’m confident that the Board is committed to do all that is needed to be a truly quality driven organisation. That is the only outcome that is acceptable to me.