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The NHS in Wales, like health services across the UK, has been experiencing significant pressures in recent weeks.


Winter is a very busy period for our health, social care and social services – urgent and emergency care services in Wales, in particular, have experienced significant pressures over the Christmas period and into the New Year. This is not a Welsh problem – the NHS throughout the UK is under pressure as a result of increased demand from an influx of sick patients.


I would like to pay tribute to all health and social care staff across Wales who have worked tirelessly, often in difficult situations, to ensure that those people who have needed urgent and emergency care have received high\-quality treatment and services and have been treated with care and compassion.  


Health boards, the Welsh Ambulance Service and local authorities worked closely together throughout 2014 to develop integrated plans for this winter, which focused on staffing cover over the Christmas and New Year period. The plans also focused on maintaining patient flow through the healthcare system, including early discharge planning, timely assessment of care and support needs, reablement and step down provision, as well as re\-starting  packages of care automatically to ensure people can be discharged from hospital as soon as they are well enough.


However, despite these robust plans being in place, the pressures have been significant, including:


 


* GP out\-of\-hour services experienced their busiest festive period since they were established. In Abertawe Bro Morgannwg University Health Board area, the out\-of\-hours service received some 1,800 calls on a single weekend between Christmas and New Year;
* The Welsh Ambulance Service saw a significant rise in the most critically\-ill patients using its services, with unprecedented levels of demand over recent weeks. Management information indicates that there were 725 category A calls on New Year’s day – an increase of around 225 incidents on what is considered a normal day and a 17\.5% increase on New Year’s day in 2014;
* Hospital emergency departments across Wales have reported an increase in admissions of patients with acute conditions, complex needs and dependency.


 


The NHS in Wales has seen a rise in the number of elderly patients who have complex needs and chronic conditions who need to be treated at and admitted to hospital. This is particularly challenging for Wales, which has the highest proportion of people over 85 in the UK.  


NHS Wales is treating more acutely ill patients, who have higher levels of dependency, which means they need to spend more time in hospital. This impacts on patient flow through the healthcare system, as people cannot be discharged from hospital as quickly as they would be at other times of the year and there are consequently fewer beds available for patients to be admitted to.


Health boards are ensuring all available beds are used to provide care and treatment for the most poorly patients. This has unfortunately, but inevitably, led to some delays in providing some planned operations to ensure there are beds available for those who require urgent medical attention.


Some health boards have opened extra surge capacity above that identified in their integrated winter plans in response to these pressures, however the service is also considering what further immediate action it can take.


The NHS is also dealing with an influx of people with a range of winter illnesses, including norovirus, viral illnesses, respiratory, cardiac and stroke conditions. We also know that flu is circulating in the community in Wales – there have already been a number of significant flu outbreaks reported in hospital and care home settings. One of the flu strains circulating appears to particularly affect elderly and vulnerable people.


Health boards and Public Health Wales are working together to contain these outbreaks, which includes offering antiviral drugs to people who are sick or at risk of spreading the infection. The Chief Medical Officer for Wales has also advised GPs to offer antiviral drugs to at\-risk people who they suspect may have flu and, wherever possible, patients will be treated at home to help reduce pressures on hospital services.


The free flu vaccination is still available to people over 65; those under 65 years who are in an at\-risk group; to pregnant women and to children aged two, three and four. Anyone who has not yet been vaccinated should contact their GP or pharmacy to have the vaccine as soon as possible as this will provide protection for the remainder of the season. Frontline healthcare workers can also receive the free flu vaccination, which will ensure they and their vulnerable patients are protected against flu and its complications while also helping to maintain essential healthcare services during this very busy period.


Emergency ambulance service clinicians continue to treat patients at the scene of their illness or injury; stabilise critically\-ill patients and take people to and from hospital when appropriate. I have made it clear that health boards must work with their partners in order to reduce handover delays at A\&E departments to ensure the ambulance service is able to respond quickly to other people who need emergency or life\-saving treatment.


It is testament to the dedication and commitment of NHS, social care and social services staff who have worked hard to ensure our urgent and emergency care services are safely delivered so patients are able to remain at home or can return home as quickly as possible, during times of significant pressure. I would like to take this opportunity to place on record my thanks to all staff for their efforts.


The public can help the NHS by choosing well and considering whether they need to go to A\&E when they are injured or unwell or whether another local health service can help or if they can look after themselves with advice from NHS Direct Wales. Our Choose Well campaign can help people decide where to go when they need help; what different NHS services do and when they should be used.


Choosing Well means people get the best treatment for their particular condition and allows busy NHS services to help people who need them most at this time.


NHS Direct Wales can be contacted on 0845 46 47\.







Translation:


 
Mae'r GIG yng Nghymru, fel gwasanaethau iechyd ar draws y DU, wedi bod o dan bwysau sylweddol yn yr wythnosau diwethaf.

Mae'r gaeaf yn gyfnod prysur iawn i'n gwasanaethau iechyd, gofal cymdeithasol a'n gwasanaethau cymdeithasol \- mae gwasanaethau gofal brys yng Nghymru, yn arbennig, wedi bod o dan bwysau sylweddol dros gyfnod y Nadolig a'r Flwyddyn Newydd. Nid yng Nghymru yn unig y mae hyn y broblem \- mae'r GIG ledled y DU o dan bwysau o ganlyniad i alw cynyddol gan lif o gleifion sâl.

Hoffwn ddiolch i holl staff y maes iechyd a gofal cymdeithasol ledled Cymru sydd wedi gweithio'n ddiflino, yn aml mewn sefyllfaoedd anodd, i sicrhau bod y rheini sydd angen gofal brys wedi derbyn triniaeth a gwasanaethau o'r ansawdd uchaf ac wedi cael eu trin gyda gofal a thosturi.  

Bu'r byrddau iechyd, Gwasanaeth Ambiwlans Cymru a'r awdurdodau lleol yn cydweithio'n agos drwy gydol 2014 i ddatblygu cynlluniau integredig ar gyfer y gaeaf, a oedd yn canolbwyntio ar lefelau staffio dros y Nadolig a'r Flwyddyn Newydd. Roedd y cynlluniau hefyd yn canolbwyntio ar gynnal llif cleifion drwy'r system gofal iechyd, gan gynnwys cynllunio ar gyfer rhyddhau cleifion yn gynnar, asesiadau cyflym o anghenion gofal a chymorth, ailalluogi a darpariaeth 'cam i lawr', yn ogystal ag ailgychwyn rhaglenni gofal yn awtomatig i sicrhau bod pobl yn gallu cael eu rhyddhau o'r ysbyty cyn gynted â'u bod yn teimlo'n ddigon da.

Ond, er gwaetha'r cynlluniau cadarn hyn, mae'r pwysau wedi bod yn sylweddol:

* Mae’r gwasanaethau meddygon teulu y tu allan i oriau wedi cael y Nadolig prysuraf ers eu sefydlu. Yn ardal Bwrdd Iechyd Prifysgol Abertawe Bro Morgannwg, cafodd y gwasanaeth y tu allan i oriau tua 1,800 o alwadau ar un penwythnos rhwng y Nadolig a'r Flwyddyn Newydd.
* Mae Gwasanaeth Ambiwlans Cymru wedi gweld cynnydd sylweddol yn nifer y cleifion difrifol wael sy'n defnyddio'r gwasanaethau, gyda lefelau annisgwyl o alw dros yr wythnosau diwethaf. Cafwyd 725 o alwadau Categori A ddydd Calan \- cynnydd o tua 225 o achosion o gymharu â'r hyn a gaiff ei ystyried yn ddiwrnod arferol, a chynnydd o 17\.5% o gymharu â dydd Calan 2014;
* Mae adrannau brys ysbytai ledled Cymru wedi cofnodi cynnydd yn nifer y cleifion sy'n cael eu derbyn i'r ysbyty gyda chyflyrau acìwt, anghenion cymhleth a'r rheini sy'n ddibynnol.

Mae'r GIG yng Nghymru wedi gweld cynnydd yn nifer y cleifion hŷn ag anghenion cymhleth a chyflyrau cronig sydd angen cael eu trin mewn ysbyty. Mae hyn yn hynod o heriol i Gymru, sydd â'r gyfran uchaf o bobl dros 85 oed yn y DU.  

Mae GIG Cymru yn trin mwy o gleifion sy'n ddifrifol wael, ac sydd â lefelau uwch o ddibyniaeth, sy'n golygu bod angen iddynt dreulio mwy o amser yn yr ysbyty. Mae hyn yn cael effaith ar lif cleifion drwy'r system gofal iechyd, gan nad oes modd rhyddhau pobl o'r ysbyty mor gyflym ag ar adegau eraill o'r flwyddyn, ac o ganlyniad, mae llai o welyau ar gael i gleifion.

Mae’r byrddau iechyd yn sicrhau bod pob gwely sydd ar gael yn cael ei ddefnyddio i ddarparu gofal a thriniaeth i'r cleifion mwyaf sâl. Yn anffodus, ond yn anochel, mae hyn wedi arwain at oedi wrth gynnal rhai llawdriniaethau oedd wedi'u trefnu, er mwyn sicrhau bod gwelyau ar gael i'r rheini sydd angen sylw meddygol ar frys.

Mae rhai byrddau iechyd wedi defnyddio eu gwelyau wrth gefn ar lefelau y tu hwnt i’w cynlluniau integredig ar gyfer y gaeaf, a hynny mewn ymateb i'r pwysau hyn, fodd bynnag mae'r gwasanaeth hefyd yn ystyried pa gamau pellach i'w cymryd ar unwaith.

Mae'r GIG hefyd yn ymdrin â llif o bobl ag amrywiaeth o salwch sy'n gysylltiedig â'r gaeaf, gan gynnwys y norofeirws, salwch feirysol, a chyflyrau sy'n ymwneud ag anadlu, y galon a str c. Rydym hefyd yn gwybod bod y ffliw yn lledaenu mewn cymunedau yng Nghymru \- mae nifer o achosion o'r ffliw eisoes wedi cael eu cofnodi mewn ysbytai a chartrefi gofal. Mae’n ymddangos bod un straen o'r ffliw sy'n lledaenu yn effeithio'n arbennig ar bobl hŷn sy'n agored i niwed.

Mae Byrddau Iechyd ac Iechyd Cyhoeddus Cymru yn cydweithio i reoli’r achosion hyn, ac mae hyn yn cynnwys gynnig cyffuriau gwrthfeirysol i bobl sy'n sâl neu sydd mewn perygl o ledaenu'r haint. Mae Prif Swyddog Meddygol Cymru hefyd wedi cynghori meddygon teulu i gynnig cyffuriau gwrthfeirysol i bobl sy’n agored i niwed, y maent yn amau sy'n dioddef o'r ffliw, a phryd bynnag y bo’n bosibl, caiff cleifion eu trin yn y cartref er mwyn helpu i leihau pwysau ar wasanaethau’r ysbyty.

Mae'r brechiad ffliw am ddim ar gael o hyd i bobl dros 65 oed; i bobl dan 65 oed sy’n perthyn i grŵp agored i niwed; i fenywod beichiog ac i blant sy'n ddwy, tair a phedair blwydd oed. Dylai unrhyw un sydd heb gael brechiad eto gysylltu â'i feddyg teulu neu'r fferyllfa i gael y brechiad cyn gynted â phosibl, a bydd yn ei amddiffyn am weddill y tymor. Gall gweithwyr iechyd y rheng flaen hefyd gael brechiad ffliw am ddim, a fydd yn sicrhau eu bod nhw eu hunain, a'u cleifion bregus ,yn cael eu hamddiffyn yn erbyn y ffliw a'i gymhlethdodau, a hefyd yn helpu i gynnal gwasanaethau gofal iechyd hanfodol yn ystod y cyfnod prysur hwn.

Mae clinigwyr y gwasanaeth ambiwlans brys yn parhau i drin salwch neu anafiadau cleifion yn y fan a’r lle; yn sefydlogi cleifion sy'n ddifrifol wael ac yn mynd â phobl i'r ysbyty ac o'r ysbyty lle y bo'n briodol. Rwyf wedi egluro bod yn rhaid i'r byrddau iechyd weithio gyda'u partneriaid i leihau’r oedi wrth drosglwyddo cleifion mewn adrannau brys, er mwyn sicrhau bod y gwasanaeth ambiwlans yn gallu ymateb yn gyflym i bobl eraill sydd angen triniaeth frys, neu driniaeth i achub eu bywydau.

Mae hyn yn brawf o ymroddiad ac ymrwymiad staff y GIG, gofal cymdeithasol a gwasanaethau cymdeithasol sydd wedi gweithio'n galed i sicrhau bod ein gwasanaethau gofal brys yn cael eu darparu mewn modd diogel, fel bod cleifion yn gallu aros yn y cartref neu'n gallu mynd adref mor gyflym â phosibl, yn ystod cyfnod o bwysau sylweddol. Hoffwn fanteisio ar y cyfle hwn i ddiolch i'r holl staff am eu hymdrechion.

Gall y cyhoedd helpu'r GIG drwy wneud dewis doeth ac ystyried a oes angen iddynt fynd i'r adran frys pan maent yn cael anaf neu salwch, a all gwasanaeth iechyd lleol arall helpu, neu a ydynt yn gallu gofalu am eu hunain gyda chyngor gan Galw Iechyd Cymru. Gall ein hymgyrch Dewis Doeth helpu pobl i benderfynu at bwy i droi i gael yr help sydd ei angen arnynt; beth mae gwahanol wasanaethau'r GIG yn eu gwneud a phryd y dylid eu defnyddio.

Drwy wneud Dewis Doeth mae pobl yn cael y driniaeth orau ar gyfer eu cyflwr penodol ac mae'n caniatáu gwasanaethau prysur y GIG i helpu’r bobl sydd fwyaf eu hangen ar yr adegau hynny.

Gallwch gysylltu â Galw Iechyd Cymru ar 0845 46 47\.