Translate the text from English to Welsh.



 
I am making this statement to provide Members with an update on the current position in relation to winter pressures across our health and care system.


Members will be aware that extensive preparation has gone into planning for winter throughout Wales and across organisational boundaries, and that planning for this winter began immediately after the end of the 2017/18 winter period. 


In collaboration with NHS Wales, local authorities and partners, we have learned lessons from previous winters to improve planning processes, and following the evaluation of winter 2017/18, there is increased recognition of the need for national leadership and support.  It was in this context that I made the decision to provide additional funding of £35m to support the NHS and social care partners in Wales earlier this financial year to ensure local health and care teams are as prepared as they can be for the winter period.


We have been open that last winter was exceptionally difficult and we saw spikes in demand which, at times, were unprecedented, which impacted on the ability of services to manage and cope with demand and saw performance against key indicators deteriorate.


I have been encouraged to observe that escalation levels at hospital sites across Wales have generally been lower over this past festive period when compared to the previous year.  We have seen fewer sites at the highest level of escalation and those which have seen increased pressures have been able to de\-escalate more quickly, which is a real indication of improved resilience of front line services.


Pressures are visible all year round and the challenges faced by front line staff over winter should be viewed in the context of sustained and relentless pressure over recent months.  We also know there are local pinch points and that pressures will continue as temperatures drop and the ‘flu season progresses. 


Public Health Wales has confirmed that the ‘flu season has started. Current levels of activity are low but are increasing and clinical evidence suggests that we can expect to see a further increase in attendances at GP surgeries and Emergency Departments for respiratory conditions within the next week or so following the recent cold snap.


Since March 2018, substantial focus has been put on forecasting the volumes of people likely to access Emergency Department services this winter, as well as the numbers of patients who will need to be admitted to a hospital bed as an emergency.  


NHS management information suggests the majority of people have been assessed, treated and admitted or discharged within four hours to date over winter.  However, NHS management information also points to a difficult festive period for ED staff when compared to five years ago:


* There was a 14% increase in attendances at EDs over the festive period (22 – 29 December 2018\) when compared to the same period five years ago;
* Emergency admissions of patients to hospital beds from ED were 9% higher over the festive period when compared to the same period five years ago; and
* A 13% increase in emergency admissions of people over the age of 85 when compared to the same period five years ago when compared to the same period five years ago.


This level of activity has come at a time when primary care services have reported pressure, with GPs and primary care services across Wales reporting increased demand for appointments over the festive period when compared to the same period last year.  


The ambulance service has also received additional call volumes for the amber category in particular.  NHS management information suggests call volumes for ambulance services in December 2018 were the highest since the new clinical response model was introduced over three years ago.


Despite these pressures, Welsh Ambulance Services management information suggests performance has been sustained above the national target for immediately life\-threatening incidents. Encouragingly, a significant reduction in ambulance patient handover delays has also been reported over recent week when compared to the previous year.


It has been, and continues to be, a difficult period for front line staff and it is testament to their commitment that the vast majority of people are receiving a professional response and timely care in line with public expectation. 


I am also pleased to provide an update on one of the additional initiatives planned to support people and staff this winter. Members will know that the British Red Cross has been commissioned to provide winter schemes at eight hospital sites across Wales which are intended to support patients and staff in Emergency Departments. The scheme is also intended to transport relevant patients home, helping them to resettle by buying food, following up with a welfare call and connecting to community services. 


I am pleased to report that Red Cross teams have supported over 2500 people already since the schemes were introduced in mid December, with patients and carers helped in Emergency Departments and dozens of vulnerable, older people resettled at home, thus avoiding unnecessary admission. 


While early indications are that rigorous planning has contributed to greater resilience to date over the winter period, despite increases in ambulance activity, attendances at Emergency Departments and emergency admissions of older patients when compared with previous years, we know that pressure is beginning to increase on services across the system.


There are further opportunities to strengthen local responsiveness and delivery by allocating additional funding at this early stage of the winter period.  I have, therefore, agreed to provide additional funding of up to £4m of new investment to NHS Wales to support initiatives which will add value, improve patient experience, clinical outcomes and staff well\-being through this winter.  The money will come from the existing central Health and Social Services budget and will see health boards working with the Welsh Ambulance Service, and Local Authority and third sector partners to treat and care for the increased demand and need across our system.  


Officials will continue to monitor delivery of services closely and work alongside NHS Wales and partner organisations to seek assurance on timeliness and quality of care over the winter period.







Translation:


 
Rwy’n gwneud y datganiad hwn i roi’r wybodaeth ddiweddaraf i'r Aelodau am y sefyllfa bresennol mewn perthynas â phwysau'r gaeaf ar draws ein system iechyd a gofal.


Bydd yr Aelodau yn ymwybodol bod cryn dipyn o waith paratoi ar gyfer y gaeaf wedi digwydd ledled Cymru ac ar draws ffiniau sefydliadol, a bod y gwaith cynllunio ar gyfer y gaeaf hwn wedi dechrau yn syth ar ôl i gyfnod gaeaf 2017/18 ddod i ben. 


Mewn cydweithrediad â GIG Cymru, awdurdodau lleol a phartneriaid eraill, rydym wedi dysgu gwersi o'r gaeafau diwethaf i wella prosesau cynllunio, ac ar ôl gwerthuso gaeaf 2017/18 mae mwy o gydnabyddiaeth bod angen arweiniad a chefnogaeth genedlaethol. Yn y cyd\-destun hwn penderfynais ddarparu £35m o gyllid ychwanegol i gefnogi'r GIG a phartneriaid gofal cymdeithasol yng Nghymru yn gynharach yn y flwyddyn ariannol bresennol i sicrhau bod timau iechyd a gofal lleol mor barod â phosib ar gyfer y gaeaf.


 


Rydym wedi dweud yn agored i’r gaeaf diwethaf fod yn eithriadol o anodd, gyda lefelau'r galw yn annisgwyl o uchel ar adegau gan effeithio ar allu gwasanaethau i reoli a dygymod, a'r perfformiad yn erbyn rhai dangosyddion allweddol yn dirywio.


Rwyf wedi cael fy nghalonogi wrth weld bod lefelau uwchgyfeirio mewn ysbytai ar draws Cymru wedi bod yn gyffredinol is dros gyfnod yr ŵyl, o gymharu â'r flwyddyn flaenorol.  Gwelwyd llai o safleoedd wedi'u huwchgyfeirio i'r lefel uchaf, a llwyddodd y rhai dan bwysau uwch i is\-gyfeirio yn gynt, sy'n arwydd bod gwasanaethau rheng flaen yn fwy cadarn.


Mae pwysau ar y gwasanaeth drwy gydol y flwyddyn, ac fe ddylai'r heriau sy'n wynebu staff rheng flaen dros y gaeaf gael eu gweld yng nghyd\-destun pwysau parhaus a di\-baid dros y misoedd diwethaf. Gwyddom hefyd bod mannau penodol dan bwysau arbennig yn lleol ac y bydd y pwysau yn parhau wrth i'r tymheredd syrthio ac wrth i dymor y ffliw barhau. 


Mae Iechyd Cyhoeddus Cymru wedi cadarnhau bod tymor y ffliw wedi dechrau. Ar hyn o bryd mae'r lefelau yn isel, ond yn cynyddu, ac mae'r dystiolaeth glinigol yn awgrymu y gallwn ddisgwyl gweld cynnydd pellach yn y nifer sy'n ymweld â meddygfeydd ac Adrannau Brys am gyflyrau anadlol dros yr wythnos neu ddwy nesaf yn dilyn y tywydd oer diweddar.


Ers mis Mawrth 2018, rhoddwyd cryn dipyn o sylw i ragweld nifer y bobl sy'n debyg o ddefnyddio gwasanaethau'r Adrannau Brys dros y gaeaf, yn ogystal â nifer y cleifion fydd angen eu derbyn i'r ysbyty fel achos brys.  


Mae gwybodaeth reoli'r GIG yn awgrymu bod y rhan fwyaf o bobl wedi cael eu hasesu, eu trin a'u derbyn neu ryddhau o fewn pedair awr hyd yma dros y gaeaf. Fodd bynnag, mae gwybodaeth reoli'r GIG hefyd yn dangos cyfnod anodd dros y gwyliau i staff Adrannau Brys o gymharu â phum mlynedd yn ôl:


* Gwelwyd 14% o gynnydd yn y nifer aeth i'r Adrannau Brys dros yr ŵyl (22 \- 29 Rhagfyr 2018\) o gymharu â’r un cyfnod pum mlynedd yn ôl
* Roedd derbyniadau brys cleifion o'r Adrannau Brys i welyau ysbyty 9% yn uwch dros yr ŵyl o gymharu â’r un cyfnod pum mlynedd yn ôl
* Gwelwyd cynnydd o 13% mewn derbyniadau brys ymysg pobl dros 85 oed o gymharu â’r un cyfnod pum mlynedd yn ôl.


Daw hyn ar adeg pan fo gwasanaethau gofal sylfaenol yn adrodd am bwysau arnynt, gyda'r Meddygon Teulu a'r gwasanaethau gofal sylfaenol ar draws Cymru yn adrodd am fwy o alw am apwyntiadau dros yr ŵyl o gymharu â'r un cyfnod llynedd.  


Mae'r gwasanaeth ambiwlans hefyd wedi cael mwy o alwadau yn y categori oren yn arbennig. Mae gwybodaeth reoli'r GIG yn awgrymu bod nifer y galwadau am wasanaethau ambiwlans ym mis Rhagfyr 2018 ar ei uchaf ers i'r model ymateb clinigol newydd gael ei gyflwyno dros dair blynedd yn ôl. 


Er gwaetha'r pwysau hwn, mae gwybodaeth reoli Gwasanaethau Ambiwlans Cymru yn awgrymu bod y perfformiad wedi'i gynnal uwchlaw'r targed cenedlaethol ar gyfer digwyddiadau lle mae bywyd yn y fantol. Yn galonogol iawn, adroddwyd hefyd am ostyngiad sylweddol mewn oedi wrth drosglwyddo cleifion o ofal ambiwlans dros yr wythnos ddiwethaf, o gymharu â'r flwyddyn flaenorol.


Mae wedi bod yn gyfnod anodd i staff y rheng flaen, ac mae hynny'n parhau. Diolch i'w hymroddiad mae'r mwyafrif llethol yn derbyn ymateb proffesiynol a gofal amserol yn unol â disgwyliadau'r cyhoedd. 


Rwyf hefyd yn falch o roi'r wybodaeth ddiweddaraf am un o'r mentrau ychwanegol sydd wedi'u cynllunio i gefnogi pobl a staff y gaeaf hwn. Bydd yr Aelodau'n gwybod bod y Groes Goch Brydeinig wedi'i chomisiynu i ddarparu cynlluniau'r gaeaf mewn wyth o ysbytai ar draws Cymru, gyda'r bwriad o helpu cleifion a staff mewn Adrannau Brys. Bwriad arall y cynllun yw cludo cleifion perthnasol adref, a'u helpu i setlo drwy brynu bwyd, galw i gadw llygad ar eu lles a chysylltu â gwasanaethau cymunedol. 


Rwy'n falch o ddweud bod timau'r Groes Goch eisoes wedi helpu dros 2500 o bobl ers cyflwyno'r cynlluniau ganol Rhagfyr, gyda'r cleifion a'r gofalwyr yn cael cymorth mewn Adrannau Brys a dwsinau o bobl hŷn, agored i niwed yn cael eu setlo yn y cartref, gan osgoi derbyniadau diangen i'r ysbyty. 


Mae’r arwyddion cychwynnol yn dangos bod cynllunio trylwyr wedi cyfrannu at fwy o gadernid hyd yma dros y gaeaf, er gwaetha’r cynnydd yng ngweithgarwch y gwasanaeth ambiwlans, presenoldeb mewn Adrannau Brys a derbyniadau brys ymysg cleifion hŷn o gymharu â’r blynyddoedd blaenorol, ond rydym yn gwybod bod y pwysau yn dechrau cynyddu ar wasanaethau ar draws y system.


Mae cyfleoedd pellach i gryfhau ymateb a darpariaeth leol drwy neilltuo cyllid ychwanegol yn ystod y cam cynnar hwn o gyfnod y gaeaf. Rwyf felly wedi cytuno i ddarparu cyllid ychwanegol o hyd at £4m o fuddsoddiad newydd i GIG Cymru i gefnogi mentrau a fydd yn ychwanegu gwerth, gan wella profiad y claf, canlyniadau clinigol a llesiant staff drwy gydol y gaeaf. Bydd yr arian yn dod o gyllideb ganolog bresennol Iechyd a Gwasanaethau Cymdeithasol, ac yn golygu bod byrddau iechyd yn gweithio gyda Gwasanaeth Ambiwlans Cymru, Awdurdodau Lleol a phartneriaid trydydd sector i drin a gofalu i ateb y galw a’r angen cynyddol ar draws ein system.


Bydd swyddogion yn parhau i fonitro'r gwaith o ddarparu gwasanaethau a chydweithio â GIG Cymru a sefydliadau partner i geisio sicrwydd am brydlondeb ac ansawdd y gofal dros y gaeaf.