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I wish to update Assembly Members on the range of actions which have been taken by the Welsh Government following the joint Wales Audit Office/Healthcare Inspectorate Wales report on Governance Arrangements at Betsi Cadwaladr University Health Board.


Whilst the report does make sobering reading, it also provides reassurance that the national oversight, inspection and supervision arrangements were able to detect and respond to the emerging situation in Betsi Cadwaladr Health Board.  From the outset of the WAO/HIW review my officials have held regular meetings with WAO and HIW and have been working to assist the Health Board on a range of performance, governance and quality and safety issues.  Therefore, much of our support to deal with the Review’s recommendations was either already in place or planned prior to the Review’s publication.


Turning to the details of Welsh Government current support for the Health Board, I have already announced that David Jenkins, Chair of Aneurin Bevan Health Board, will be providing assistance to the Health Board until a new Chair is in post.  This arrangement has already commenced and we have already advertised for a replacement Chair. This process will be completed within the next two months.   The advertisement for the Vice Chair will be placed very shortly.


In addition, David Sissling, Chief Executive of the NHS, has ensured arrangements are in place to provide support to the Executive Team and the wider organisation to increase the team’s capacity to respond to the Review recommendations.   This support is being provided by  


* Paul Roberts, Chief Executive of Abertawe Bro Morgannwg University Health Board,
* Richard Bowen, Director of Planning at Aneurin Bevan Local Health Board
* Bruce Ferguson, recently retired Medical Director at Abertawe Bro Morgannwg University Health Board


Each of the above will provide sufficient time to assist the Board to implement the review recommendations. Paul Roberts will be spending 3 or 4 days a week on site.  In doing this work, the individuals will have the support of both myself and David Sissling.  They will carry our authority to take the actions required to see the Board through this transitional period. This support team will remain in place until at least the early autumn but we will extend this period of support if necessary


Furthermore, the Chief Medical Officer has requested Public Health Wales to continue to provide support to the Health Board to ensure infection control systems are robust through monthly progress monitoring.  At the present time PHW's Welsh Healthcare Associated Infection team are working with BCU to replicate the epidemiological analyses that were undertaken in Ysbyty Glan Clwyd across the other two sites at BCUHB.  This work should be completed in the next couple of months.  The PHW team are also providing advice and support to the Executive Nurse Lead on infection control issues.


The Health Board has also engaged the services of Professor Brian Duerden, formerly the Inspector of Microbiology at the Department of Health.  Professor Duerden is an expert in infection prevention.  He will review relevant procedures and produce recommendations for improvement.  The terms of reference for his work are to:


1. Provide evidence based timely advice to the Health Board on the appropriateness and robustness of its governance and management arrangements for health care associated infections, in particular C. Difficile.
2. To identify all opportunities to strengthen these arrangements so that the incidence of infection is reduced and the board is able to identify and take appropriate action as early as possible should an outbreak occur.


The Health Board expects to receive an initial report from Professor Duerden by the end of July.  To further strengthen their response in this area, the Health Board has already appointed an external specialist Nurse Consultant in infection control.


The Health Board has been advised for some months to appoint a Chief Operating Officer, a Senior Clinical Leader and Turnaround experts and I understand this process is now well advanced.  The Health Board are also working with an external consultancy to secure support on planning and financial matters.


My Officials are also providing support on a day to day basis to members of the Executive Team and Board as required.  The Chief Medical Officer and Chief Nursing Officer for Wales are already working closely with the Acting Medical Director and newly appointed Director of Nursing as well as the BMA and RCN to strengthen clinical engagement.  This is an important area – we need to ensure all staff in the Health Board feel a part of and play a part in the processes of improvement.


It is clearly vital that the Board maintains a focus on matters of quality and safety.  In order to ensure that this takes place strengthened surveillance arrangements have been put in place in this area and I am receiving regular reports on a range of key indicators.


The Health Board itself now needs to draw on this support and take urgent and sustained action in relation to resolving the issues in relation to:


* Board governance, information and support
* Clinical governance, leadership and engagement
* Planning systems, including for service change processes
* Performance and quality and safety management arrangements


A formal review of the Board’s progress will be undertaken across all these areas at the end of September and I will update Assembly Members at that point.


Finally I would, once again, like to pay tribute to the professionalism and commitment of NHS staff at the Health Board.  It is a difficult time but they will, I know, continue to rise to the challenge and deliver high standards of care to the people of North Wales.







Translation:


 
Hoffwn roi’r diweddaraf i Aelodau’r Cynulliad ar amryw gamau y mae Llywodraeth Cymru wedi’u cymryd yn dilyn yr adroddiad ar y cyd gan Swyddfa Archwilio Cymru ac Arolygiaeth Gofal Iechyd Cymru ar y Trefniadau Llywodraethu ym Mwrdd Iechyd Prifysgol Betsi Cadwaladr.

Er nad yw’r adroddiad yn ddarlleniad hawdd, mae hefyd yn rhoi sicrwydd i’r perwyl y llwyddodd y trefniadau trosolwg, arolygu a goruchwylio cenedlaethol i ganfod ac ymateb i’r sefyllfa a ddaeth i’r amlwg ym Mwrdd Iechyd Betsi Cadwaladr.  Ers cychwyn yr adolygiad gan Swyddfa Archwilio Cymru ac Arolygiaeth Gofal Iechyd Cymru, mae fy swyddogion wedi cynnal cyfarfodydd rheolaidd gyda nhw ac wedi bod yn gweithio i gynorthwyo’r Bwrdd Iechyd ag amryw o faterion sy’n ymwneud â llywodraethu, perfformiad, ac ansawdd a diogelwch. Felly, roedd llawer o’r agweddau ar ein cefnogaeth i ymdrin ag argymhellion yr Adolygiad naill ai eisoes yn eu lle neu yn yr arfaeth cyn i’r Adolygiad gael ei gyhoeddi.

O ran manylion y gefnogaeth y mae Llywodraeth Cymru yn ei roi i’r Bwrdd Iechyd, rwyf wedi cyhoeddi eisoes y bydd David Jenkins, Cadeirydd Bwrdd Iechyd Aneurin Bevan, yn cynorthwyo’r Bwrdd Iechyd hyd nes y bydd Cadeirydd newydd yn ei swydd. Mae’r trefniant hwn bellach wedi cychwyn ac rydym eisoes wedi hysbysebu am Gadeirydd newydd. Bydd y broses hon wedi dod i’w therfyn o fewn y ddau fis nesaf. Cyhoeddir yr hysbyseb am Ddirprwy Gadeirydd cyn bo hir.

Hefyd, mae David Sissling, Prif Weithredwr y GIG, wedi sicrhau bod trefniadau ar waith i gefnogi’r Tîm Gweithredol a’r sefydliad ehangach er mwyn gwella gallu’r tîm i ymateb i argymhellion yr Adolygiad. Darperir y gefnogaeth hon gan;

* Paul Roberts, Prif Weithredwr Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg;
* Richard Bowen, Cyfarwyddwr Cynllunio Bwrdd Iechyd Lleol Aneurin Bevan;
* Bruce Ferguson, sydd newydd ymddeol fel Cyfarwyddwr Meddygol Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg.

Bydd pob un o’r uchod yn neilltuo amser digonol i gynorthwyo’r Bwrdd i roi argymhellion yr Adolygiad ar waith. Bydd Paul Roberts yn treulio 3 neu 4 diwrnod yr wythnos ar y safle. Byddaf i a David Sissling yn cefnogi’r unigolion wrth iddynt wneud y gwaith hwn. Bydd ganddynt ein hawdurdod i gymryd y camau gofynnol i fynd â’r Bwrdd drwy’r cyfnod hwn o newid. Bydd y tîm cefnogi hwn yn ei le tan ddechrau’r hydref, o leiaf, ond byddwn yn estyn y cyfnod hwn os oes angen.

Ar ben hyn, mae’r Prif Swyddog Meddygol wedi gofyn i Iechyd Cyhoeddus Cymru barhau i gefnogi’r Bwrdd Iechyd i sicrhau bod systemau rheoli heintiau trylwyr ar waith drwy fonitro cynnydd bob mis. Ar hyn o bryd mae’r tîm Heintiau sy’n Gysylltiedig â Gofal Iechyd yn Iechyd Cyhoeddus Cymru yn gweithio gyda Bwrdd Iechyd Prifysgol Betsi Cadwaladr i ailadrodd y dadansoddiadau epidemiolegol a gynhaliwyd yn Ysbyty Glan Clwyd mewn dau o safleoedd eraill y Bwrdd Iechyd. Dylai’r gwaith hwn fod wedi’i gwblhau o fewn y misoedd nesaf. Mae tîm Iechyd Cyhoeddus Cymru hefyd yn rhoi cyngor a chefnogaeth i’r Arweinydd Nyrsio Gweithredol ar faterion sy’n ymwneud â rheoli heintiau.

Mae’r Bwrdd Iechyd hefyd wedi gofyn am wasanaeth yr Athro Brian Duerden, cyn Arolygydd Microbioleg yn yr Adran Iechyd. Mae’r Athro Duerden yn arbenigwr mewn atal heintiau. Bydd yn adolygu’r gweithdrefnau perthnasol ac yn gwneud argymhellion ar gyfer gwelliant. Cylch gorchwyl ei waith yw:

1. Rhoi cyngor amserol ar sail tystiolaeth i’r Bwrdd Iechyd ynghylch pa mor briodol a thrylwyr y mae ei drefniadau llywodraethu a rheoli ar gyfer heintiau sy’n gysylltiedig â gofal iechyd, yn arbennig C. Difficile.
2. Nodi’r holl gyfleoedd i gryfhau’r trefniadau hyn er mwyn lleihau achosion o heintiau ac er mwyn i’r bwrdd allu nodi a chymryd camau priodol cyn gynted â phosibl os bydd angen.

Mae’r Bwrdd Iechyd yn disgwyl cael adroddiad cychwynnol gan yr Athro Duerden erbyn diwedd mis Gorffennaf. Er mwyn cryfhau’r ymateb yn y maes hwn ymhellach, mae’r Bwrdd Iechyd eisoes wedi penodi Ymgynghorydd Nyrsio allanol gydag arbenigedd mewn rheoli heintiau.

Ers rhai misoedd, cynghorwyd y Bwrdd Iechyd i benodi Prif Swyddog Gweithredu, Uwch Arweinydd Clinigol ac arbenigwyr gweddnewid ac rwyf yn cael ar ddeall bod y broses hon yn mynd rhagddi’n dda. Mae’r Bwrdd Iechyd hefyd yn gweithio gydag ymgynghoriaeth allanol i sicrhau cymorth ar faterion cynllunio ac ariannol.

Mae fy swyddogion hefyd yn rhoi cymorth dyddiol i aelodau’r Bwrdd a’r Tîm Gweithredol yn ôl y gofyn. Mae Prif Swyddog Meddygol a Phrif Swyddog Nyrsio Cymru yn gweithio’n agos eisoes gyda’r Cyfarwyddwr Meddygol dros dro a’r Cyfarwyddwr Nyrsio a benodwyd yn ddiweddar, yn ogystal â Cymdeithas Feddygol Prydain a’r Coleg Nyrsio Brenhinol, i gryfhau’r gwaith ymgysylltu clinigol. Mae hwn yn faes pwysig – mae angen i ni sicrhau bod holl staff y Bwrdd Iechyd yn teimlo’n rhan o’r prosesau gwella a’u bod yn chwarae’u rhan ynddynt.

Yn amlwg, rhaid i’r Bwrdd ddal ati i ganolbwyntio ar faterion ansawdd a diogelwch. Er mwyn sicrhau bod hyn yn digwydd, cyflwynwyd trefniadau gwyliadwriaeth cadarnach yn y maes hwn ac rwy’n cael adroddiadau rheolaidd ar ystod o ddangosyddion allweddol.

Bellach mae angen i’r Bwrdd Iechyd ei hun fanteisio ar y gefnogaeth hon a chymryd camau brys a pharhaus i ddatrys y materion sy’n ymwneud â:

* Trefniadau llywodraethu, gwybodaeth a chefnogaeth y Bwrdd
* Llywodraethu, arweinyddiaeth ac ymgysylltiad clinigol
* Systemau cynllunio, gan gynnwys ar gyfer prosesau newid gwasanaethau
* Trefniadau rheoli perfformiad ac ansawdd a diogelwch

Cynhelir adolygiad ffurfiol o gynnydd y Bwrdd yn y meysydd hyn i gyd ddiwedd mis Medi a byddaf yn rhoi’r diweddaraf i Aelodau’r Cynulliad bryd hynny.

Yn olaf, hoffwn dalu teyrnged eto i broffesiynoldeb ac ymroddiad staff y GIG yn y Bwrdd Iechyd. Mae hwn yn gyfnod anodd, ond rwy’n gwybod y byddant yn dal ati i wynebu’r her a darparu gofal o safon uchel i bobl yn y Gogledd.