Translate the text from English to Welsh.



 
Following representations from local Members, clinicians  and community representatives I have decided to commission the Welsh Institute for Health and Social Care (WIHSC) to carry out an independent study of the issues and opportunities for providing accessible, high quality, safe and sustainable health services, which are best suited to the specific needs of people living in Mid Wales.


The outline terms of reference detailed below include consideration of patient outcomes and experiences and  working with clinicians and other professionals and their representative bodies, service providers from the health sector and other key agencies and people living in Mid Wales to explore:  how service delivery models across primary and community care and the secondary care provided at Bronglais Hospital can be best developed; opportunities to deliver more care at or close to home, such as through the use of telemedicine and telehealth; and workforce roles and models (including opportunities for partnership arrangements with specialists and the development of more 'generalist' roles).   The study will draw on the work of the Rural Health Implementation Group, which was set up to support the implementation of the Rural Health Plan, as well as international models of practice. 


This study will help to inform Local Health Board service plans.  When complete, I will expect Hywel Dda, Powys and Betsi Cadwaladr Health Boards, which are responsible for meeting the health needs of people living in Mid Wales, to respond to its findings through the refresh of Medium Term Plans undertaken by all Health Boards in the Autumn.   The NHS Wales Planning Framework, recently issued, made explicit the requirement for these plans to respond to the needs of local populations and reinforces the specific requirement to take account of delivering health care services to rural communities.  

I have asked WIHSC to take soundings from a range of key stakeholders in order to  conclude final details of the proposed study over the next 3 – 4 weeks.


 


**DRAFT/OUTLINE TERMS OF REFERENCE**


**Mid Wales Healthcare Study**  

**Aim and Objectives**


To identify the issues and potential solutions (including models) for providing accessible, high quality, safe, and sustainable healthcare services, which are best suited to meet the specific needs of those living in Mid Wales.  The study should set out what could be done now and in the future, specifically considering:


* health needs and public expectation – including: preferences for care to be delivered close to home; tackling health inequalities; Welsh language service provision; and evidence of the effect of wider determinants of health (e.g. physical and social isolation, access to transport, lower than average earnings) observed in the population of Mid Wales;
* workforce models – including profile, recruitment and retention, professional standards, service implications (quality and configuration) and future models (e.g. plans for developing the rural practitioner role, generalists, buddying arrangements with tertiary centres, outreach clinics etc.);
* service organisation models, funding, and sustainability – including plans and perspectives on the configuration best suited for delivering  the best health outcomes for patients in Mid Wales;
* innovation and application of new models – including, the extent to which there are firm proposals, or wider opportunities, for the utilisation of health technologies and telemedicine, telehealth, Skype, phone, e mail and other digital technology to improve accessibility and service quality;
* service integration – opportunities for strengthening partnership working, particularly the health and social care interface and voluntary sector providers; and
* any issues presenting along the England and Wales border.


 


  

**Method**


Two stages are envisaged.  The first, lasting around 3 \- 4 weeks, will involve initial discussions with key stakeholders to explore the issues, develop an appropriate methodology, and timetable for the study.  Whilst the second stage will be subject to the discussions undertaken in the first, a primarily qualitative method is envisaged:


* distilling the current evidence on the specific pressures facing service delivery in Mid Wales, including published literature, the Rural Health Plan (including underpinning studies), and the work of the Rural Health Plan Implementation Group;
* a review of the published literature on models of service delivery that are resulting in improved outcomes for people living in sparsely populated and predominantly rural areas;
* analysing the Medium Term Plans in development (including the available underpinning research/analysis), with a focus on their consideration of the specific and cross cutting issues facing service delivery in Mid Wales.  This should include a consideration of recent developments underway in each Health Board;
* interviews/workshops with lead managers, health and social care professionals, professional and representative bodies (including Royal Colleges and Deanery) third and independent sectors  that all have an interest in taking action to improve the health and wellbeing of people living in Mid Wales.  This should not be constrained to those working for NHS Wales; and
* interviews/workshops with local community members and groups, to understand their concerns and improvement priorities.


 


**Timetable of Events**


The contract will start immediately, with a more detailed methodology and timetable being delivered in 3 \- 4 weeks.


**Output**


The output from the first stage will be a clear methodology and timetable.  The output from the second stage will be a concise report addressing the requirements set out above and any subsequent requirements emerging through the exploratory stage of the research.  The report will clearly articulate views on what should be done to better meet the health needs of those living in Mid Wales. This will include clear advice on future sustainable models of service and will include a consideration of Bronglais Hospital.  


 







Translation:


 
Yn dilyn sylwadau gan Aelodau a chlinigwyr lleol a chynrychiolwyr cymunedol, rwyf wedi penderfynu comisiynu Athrofa Iechyd a Gofal Cymdeithasol Cymru i gynnal astudiaeth annibynnol. Diben yr astudiaeth fydd archwilio’r cyfleoedd i ddarparu gwasanaethau iechyd hygyrch, diogel, cynaliadwy ac uchel eu safon, sy’n gweddu i anghenion penodol trigolion y Canolbarth, ac agweddau ar hynny.

Mae’r cylch gorchwyl bras a nodir isod yn cynnwys ystyried canlyniadau a phrofiadau cleifion, a gweithio gyda chlinigwyr a gweithwyr proffesiynol eraill a’r cyrff sy’n eu cynrychioli, darparwyr gwasanaethau iechyd ac asiantaethau allweddol eraill, yn ogystal â thrigolion y Canolbarth, i edrych ar y canlynol: y ffordd orau o ddatblygu modelau darparu gwasanaethau ar draws gofal sylfaenol a gofal cymunedol a’r gofal eilaidd a ddarperir yn Ysbyty  Bronglais; cyfleoedd i ddarparu rhagor o ofal yn y cartref neu’n agos at y cartref, drwy ddefnyddio telefeddygaeth a theleiechyd; a datblygu rolau a modelau gweithlu (gan gynnwys cyfleoedd ar gyfer trefniadau partneriaeth ag arbenigwyr a datblygu rolau mwy ‘cyffredinol’). Bydd yr astudiaeth yn defnyddio gwaith Grŵp Gweithredu'r Cynllun Iechyd Gwledig, a sefydlwyd i gefnogi’r broses o weithredu’r Cynllun hwnnw, yn ogystal â modelau arfer rhyngwladol.

Bydd yr astudiaeth hon yn helpu i lywio cynlluniau gwasanaeth y Byrddau Iechyd Lleol. Ar ôl ei chwblhau, byddaf yn disgwyl i Fyrddau Iechyd Hywel Dda, Powys a Betsi Cadwaladr, sef y cyrff sy’n gyfrifol am ddiwallu anghenion iechyd trigolion y Canolbarth, ymateb i’w chanfyddiadau drwy adnewyddu Cynlluniau Tymor Canolig yr holl Fyrddau Iechyd yn yr Hydref. Roedd Fframwaith Cynllunio’r GIG Cymru, a gyhoeddwyd yn ddiweddar, yn datgan yn glir fod angen i’r cynlluniau hyn ymateb i anghenion y boblogaeth leol. Mae’r Fframwaith hefyd yn atgyfnerthu’r angen penodol i ystyried sut i ddarparu gwasanaethau gofal iechyd i gymunedau gwledig.

Rwyf wedi gofyn i Athrofa Iechyd a Gofal Cymdeithasol Cymru geisio barn gychwynnol amrywiaeth o randdeiliaid allweddol er mwyn dod i gasgliad gyda manylion terfynol yr astudiaeth arfaethedig dros y 3\-4 wythnos nesaf.

DRAFFT/AMLINELLIAD O’R CYLCH GORCHWYL

Astudiaeth Gofal Iechyd Canolbarth Cymru  
Nod ac Amcanion

Nodi’r materion a’r atebion posibl (gan gynnwys modelau) ar gyfer darparu gwasanaethau gofal iechyd hygyrch a diogel o ansawdd uchel, sydd fwyaf addas ar gyfer bodloni anghenion penodol y rheini sy’n byw yn y Canolbarth. Dylai’r astudiaeth nodi’r camau y gellid eu cymryd nawr ac yn y dyfodol, gan ystyried yn benodol:  


* anghenion iechyd a disgwyliadau’r cyhoedd – gan gynnwys: y dewis i ofal gael ei ddarparu’n agos at gartref; mynd i’r afael ag anghydraddoldebau iechyd; darparu gwasanaethau yn Gymraeg; a tystiolaeth ynghylch yr elfennau ehangach sy’n effeithio ar iechyd (e.e. ynysu ffisegol a chymdeithasol, mynediad at drafnidiaeth, enillion llai na’r cyfartaledd) a welir ym mhoblogaeth y Canolbarth;
* modelau gweithlu – gan gynnwys proffil, recriwtio a chadw, safonau proffesiynol, goblygiadau gwasanaethau (ansawdd a chyfluniad) a modelau ar gyfer y dyfodol (e.e. cynlluniau ar gyfer datblygu rôl yr ymarferydd gwledig, staff ‘cyffredinol’, trefniadau cyfeillio gyda chanolfannau trydyddol, clinigau allgymorth etc.);
* modelau trefnu gwasanaethau, cyllid a chynaliadwyedd – gan gynnwys cynlluniau a safbwyntiau ar y cyfluniad mwyaf addas i roi’r canlyniadau iechyd gorau i gleifion yn y Canolbarth;
* arloesi a chymhwyso modelau newydd – gan gynnwys i ba raddau y mae cynigion cadarn, neu gyfleoedd ehangach, i ddefnyddio technolegau iechyd a thelefeddygaeth, teleiechyd, Skype, ffôn, e\-bost a thechnoleg ddigidol arall i wella hygyrchedd ac ansawdd gwasanaethau;
* integreiddio gwasanaethau – cyfleoedd i gryfhau gwaith partneriaeth, yn enwedig y cysylltiad rhwng iechyd a gofal cymdeithasol a darparwyr sector gwirfoddol;
* unrhyw faterion a welir ar hyd ffin Cymru a Lloegr.

Dull

Rhagwelir dau gam. Yn y cyntaf, dros dua 3 \- 4 wythnos, cynhelir trafodaethau cychwynnol gyda rhanddeiliaid allweddol i ymchwilio i’r materion, datblygu methodoleg briodol, ac amserlen ar gyfer yr astudiaeth. Er y bydd yr ail gam yn ddibynnol ar y trafodaethau yn y cam cyntaf, rhagwelir dull ansoddol gan fwyaf:  


* crynhoi’r dystiolaeth bresennol ynghylch y pwysau penodol o ran darparu gwasanaethau yn y Canolbarth, gan gynnwys deunyddiau sydd wedi’u cyhoeddi, y Cynllun Iechyd Gwledig (gan gynnwys astudiaethau ategol) a gwaith Grŵp Gweithredu’r Cynllun Iechyd Gwledig;
* adolygiad o’r deunyddiau sydd wedi’u cyhoeddi ar fodelau darparu gwasanaethau sy’n arwain at wella canlyniadau i bobl sy’n byw mewn ardaloedd prin eu poblogaeth ac ardaloedd gwledig gan fwyaf;
* dadansoddi’r Cynlluniau Tymor Canolig wrth eu datblygu (gan gynnwys yr ymchwil/dadansoddiad ategol sydd ar gael), gyda ffocws ar ystyried y materion penodol a thrawsbynciol o ran darparu gwasanaethau yn y Canolbarth. Dylai hyn gynnwys ystyried datblygiadau diweddar ym mhob Bwrdd Iechyd;
* cyfweliadau/gweithdai gyda rheolwyr arweiniol, gweithwyr proffesiynol iechyd a gofal cymdeithasol, cyrff proffesiynol a chynrychioliadol (gan gynnwys Colegau Brenhinol a Deoniaeth), y trydydd sector a’r sector annibynnol sydd oll â buddiant mewn cymryd camau i wella iechyd a lles pobl sy’n byw yn y Canolbarth. Ni ddylid cyfyngu hyn i’r rheini sy’n gweithio i GIG Cymru;
* cyfweliadau/gweithdai gydag aelodau a grwpiau o’r gymuned leol i ddeall eu pryderon a’u blaenoriaethau ar gyfer gwella.

Amserlen Digwyddiadau

Bydd y contract yn cychwyn ar unwaith, gyda methodoleg ac amserlen fanylach o fewn 3\-4 wythnos.

Allbwn

Allbwn y cam cyntaf fydd methodoleg ac amserlen glir. Allbwn yr ail gam fydd adroddiad cryno yn mynd i’r afael â’r gofynion uchod ac unrhyw gofynion a ddaw wedi hynny drwy’r cam ymchwil. Bydd yr adroddiad yn nodi safbwyntiau’n glir ynghylch y camau y dylid eu cymryd i fodloni anghenion iechyd y rheini sy’n byw yn y Canolbarth yn well. Bydd hyn yn cynnwys cyngor clir ar fodelau gwasanaeth cynaliadwy ar gyfer y dyfodol ac ystyriaeth o Ysbyty Bronglais.