Translate the text from English to Welsh.



 
On 5 October, I published a written statement setting out the escalation levels of health boards across Wales. I said the escalation status of Betsi Cadwaladr and Cwm Taf Morgannwg university health boards were being considered separately and I would update Members following the tripartite meeting.


**Betsi Cadwaladr University Health Board**
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On 7 June, I confirmed my decision to extend the targeted intervention status of the health board to incorporate Ysbyty Glan Clwyd, focusing on the vascular service and emergency department.  


It is clear there are still a number of serious challenges the health board needs to overcome. I have accepted the advice that there should be no change to the escalation status of the health board.


**Cwm Taf Morgannwg University Health Board**
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On 7 November, I published the Independent Maternity Services Oversight Panel’s latest report.  In recognition of the progress made by Cwm Taf Morgannwg University Health Board, I announced my decision to de\-escalate maternity and neonatal services from special measures to targeted intervention.


However, following the tripartite meeting, I have accepted a recommendation that there should be further changes to the escalation status of Cwm Taf Morgannwg UniversityHealth Board.


1. The escalation status for quality governance remains at targeted intervention.
2. The escalation status for quality related to performance and long waiting times is raised to targeted intervention.
3. The escalation status for planning and finance is raised to enhanced monitoring.


The health board has made considerable progress in respect of quality governance but it is in the process of implementing a new operating model.  I need to be assured this new structure is embedded across the health board and is having a positive impact on the effectiveness of the health board’s governance processes before there can be consideration of de\-escalation in this area.  


Audit Wales and Healthcare Inspectorate Wales plan to undertake a joint follow\-up review of the health board’s quality governance arrangements early next year.  The findings and conclusions from this follow\-up review, in particular any assurance which can be provided regarding the health board’s progress in delivering against the 14 recommendations identified in the original review in 2019, will inform any future deliberations around escalation status.


Quality and performance across all areas of planned care, urgent and emergency care is a challenge for all health boards as the NHS recovers from the pandemic.  However, the challenges experienced by Cwm Taf Morgannwg University Health Board were noted as considerable, particularly in urgent and emergency care, planned care recovery, child and adolescent mental health services and cancer – these are having a negative impact on the quality of care and patient experience.  


I have clearly set out my expectations for the recovery of planned care services and the health board has not made sufficient progress against these targets.


The health board has been escalated to enhanced monitoring for planning and finance because it has not been able to submit a balanced and approved three\-year Integrated Medium Term Plan (IMTP).  It has therefore breached its statutory duty and was required to submit an annual plan, which has a considerable forecast recurrent deficit of £26\.5m.


All other organisations remain at the levels of escalation as set out in my previous update to Members.  The table below shows the previous and current escalation status of each organisation.


**Annex 1**




| **Organisation** | **February 2022** | **September 2022** | **October 2022** |
| --- | --- | --- | --- |
| Aneurin Bevan UHB | Routine arrangements | Routine arrangements | Routine arrangements |
| Betsi Cadwaladr UHB | Targeted Intervention | Targeted Intervention for mental health, Ysbyty Glan Clwyd, vascular services, leadership, engagement, finance, strategy, planning and performance | Targeted Intervention for mental health, Ysbyty Glan Clwyd, vascular services, leadership, engagement, finance, strategy, planning and performance |
| Cardiff and Vale UHB | Routine arrangements | Enhanced monitoring for planning and finance | Enhanced monitoring for planning and finance |
| Cwm Taf Morgannwg UHB | Special measures for maternity and neonatal services, targeted intervention for quality governance | Special measures for maternity and neonatal services. Targeted intervention for quality governance | Enhanced monitoring for planning and finance. Targeted intervention for maternity and neonatal services, quality governance and performance |
| Digital Health and Care Wales | Routine arrangements | Routine arrangements | Routine arrangements |
| Health Education and Improvement Wales | Routine arrangements | Routine arrangements | Routine arrangements |
| Hywel Dda UHB | Enhanced monitoring | Enhanced monitoring for quality and performance, targeted intervention for finance and planning | Enhanced monitoring for quality and performance, targeted intervention for finance and planning |
| Powys THB | Routine arrangements | Routine arrangements | Routine arrangements |
| Public Health Wales NHS Trust | Routine arrangements | Routine arrangements | Routine arrangements |
| Swansea Bay UHB | Enhanced monitoring | Enhanced monitoring for quality and performance | Enhanced monitoring for quality and performance |
| Velindre NHS Trust | Routine arrangements | Routine arrangements | Routine arrangements |
| Welsh Ambulance Services NHS Trust | Routine arrangements | Routine arrangements | Routine arrangements |


 







Translation:


 
 


Ar 5 Hydref, cyhoeddais ddatganiad ysgrifenedig yn nodi lefelau uwchgyfeirio byrddau iechyd ledled Cymru. Dywedais fod statws uwchgyfeirio byrddau iechyd prifysgol Betsi Cadwaladr a Chwm Taf Morgannwg yn cael eu hystyried ar wahân ac y byddwn yn rhoi’r wybodaeth ddiweddaraf i’r Aelodau ar ôl i’r cyfarfod teirochrog gael ei gynnal.


**Bwrdd Iechyd Prifysgol Betsi Cadwaladr** 


Ar 7 Mehefin, fe wnes i gadarnhau fy mhenderfyniad i ymestyn statws ymyrraeth wedi’i thargedu y bwrdd iechyd i gynnwys Ysbyty Glan Clwyd, gan ganolbwyntio ar y gwasanaeth fasgwlaidd a'r adran frys. 


Mae'n amlwg bod nifer o heriau difrifol yn parhau y mae angen i'r bwrdd iechyd eu goresgyn. Rwyf wedi derbyn y cyngor na ddylai fod unrhyw newid i statws uwchgyfeirio’r bwrdd iechyd.


**Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg** 


Ar 7 Tachwedd, cyhoeddais adroddiad diweddaraf y Panel Trosolwg Annibynnol ar Wasanaethau Mamolaeth. I gydnabod y cynnydd a wnaethpwyd gan Fwrdd Iechyd Prifysgol Cwm Taf Morgannwg, cyhoeddais fy mhenderfyniad i symud y gwasanaethau mamolaeth a newyddenedigol i lawr o fesurau arbennig i ymyrraeth wedi’i thargedu.


Fodd bynnag, wedi'r cyfarfod teirochrog, rwyf wedi derbyn argymhelliad y dylid gwneud newidiadau pellach i statws uwchgyfeirio Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg:


1. Mae’r statws uwchgyfeirio ar gyfer llywodraethiant ansawdd yn parhau ar ymyrraeth wedi’i thargedu.
2. Mae’r statws uwchgyfeirio ar gyfer ansawdd yn gysylltiedig â pherfformiad ac amseroedd aros hir yn cael ei godi i ymyrraeth wedi’i thargedu.
3. Mae’r statws uwchgyfeirio ar gyfer cynllunio a chyllid yn cael ei godi i fonitro uwch.


Mae’r bwrdd iechyd wedi gwneud cynnydd sylweddol o ran llywodraethiant ansawdd, ond mae wrthi’n rhoi model gweithredu newydd ar waith. Rhaid imi gael sicrwydd bod y strwythur newydd hwn yn cael ei wreiddio ar draws y bwrdd iechyd a’i fod yn cael effaith gadarnhaol ar effeithiolrwydd prosesau llywodraethiant y bwrdd iechyd cyn y gellir ystyried isgyfeirio yn y maes hwn.


Mae Archwilio Cymru ac Arolygiaeth Gofal Cymru yn bwriadu cynnal adolygiad dilynol ar y cyd o drefniadau llywodraethiant ansawdd y bwrdd iechyd yn gynnar y flwyddyn nesaf. Bydd canfyddiadau a chasgliadau’r  adolygiad dilynol hwn, yn enwedig unrhyw sicrwydd y gellir ei ddarparu ynghylch cynnydd y bwrdd iechyd o ran cyflawni yn erbyn yr 14 argymhelliad a nodwyd yn yr adolygiad gwreiddiol yn 2019, yn cyfrannu at unrhyw drafodaethau am statws uwchgyfeirio yn y dyfodol.


Mae ansawdd a pherfformiad ar draws pob maes o ofal a gynlluniwyd, gofal brys a gofal mewn argyfwng, yn her i bob bwrdd iechyd wrth i’r GIG adfer o’r pandemig. Fodd bynnag, nodwyd bod yr heriau y mae Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg yn eu hwynebu yn sylweddol, yn enwedig o ran gofal brys ac argyfwng, adfer y gwasanaeth gofal a gynlluniwyd, gwasanaethau iechyd meddwl plant a’r glasoed a chanser – mae’r rhain yn cael effaith negyddol ar ansawdd gofal a phrofiad cleifion.


Rwyf wedi nodi fy nisgwyliadau ar gyfer adfer gwasanaethau gofal a gynlluniwyd yn eglur ac nid yw’r bwrdd iechyd wedi gwneud cynnydd digonol yn erbyn y targedau hyn.


Mae’r bwrdd iechyd wedi’i uwchgyfeirio i fonitro uwch ar gyfer cynllunio a chyllid am nad yw wedi gallu cyflwyno Cynllun Tymor Canolig Integredig tair blynedd mantoledig, wedi’i gymeradwyo. Mae felly wedi mynd yn groes i’w ddyletswydd statudol a bu gofyn iddo gyflwyno cynllun blynyddol, sy’n rhag\-weld diffyg rheolaidd sylweddol o £26\.5 miliwn.


Mae pob sefydliad arall yn parhau ar y lefelau uwchgyfeirio a nodwyd yn fy niweddariad blaenorol i’r Aelodau. Mae’r tabl isod yn dangos statws uwchgyfeirio blaenorol a phresennol pob sefydliad.


**Atodiad 1**




| **Sefydliad** | **Chwefror 2022** | **Medi 2022** | **Hydref 2022** |
| --- | --- | --- | --- |
| Bwrdd Iechyd Prifysgol Aneurin Bevan | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |
| Bwrdd Iechyd Prifysgol Betsi Cadwaladr | Ymyrraeth wedi’i thargedu | Ymyrraeth wedi’i thargedu ar gyfer iechyd meddwl, Ysbyty Glan Clwyd, gwasanaethau fasgwlaidd, arweinyddiaeth, ymgysylltu, cyllid, strategaeth, cynllunio a pherfformiad | Ymyrraeth wedi’i thargedu ar gyfer iechyd meddwl, Ysbyty Glan Clwyd, gwasanaethau fasgwlaidd, arweinyddiaeth, ymgysylltu, cyllid, strategaeth, cynllunio a pherfformiad |
| Bwrdd Iechyd Prifysgol Caerdydd a’r Fro | Trefniadau arferol | Monitro uwch ar gyfer cynllunio a chyllid | Monitro uwch ar gyfer cynllunio a chyllid |
| Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg | Mesurau arbennig ar gyfer gwasanaethau mamolaeth a newyddenedigol, ymyrraeth wedi’i thargedu ar gyfer llywodraethiant ansawdd | Mesurau arbennig ar gyfer gwasanaethau mamolaeth a newyddenedigol. Ymyrraeth wedi’i thargedu ar gyfer llywodraethiant ansawdd | Monitro uwch ar gyfer cynllunio a chyllid. Ymyrraeth wedi’i thargedu ar gyfer gwasanaethau mamolaeth a newyddenedigol, llywodraethiant ansawdd a pherfformiad |
| Iechyd a Gofal Digidol Cymru | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |
| Addysg a Gwella Iechyd Cymru | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |
| Bwrdd Iechyd Prifysgol Hywel Dda | Monitro uwch | Monitro uwch ar gyfer ansawdd a pherfformiad, ymyrraeth wedi’i thargedu ar gyfer cyllid a chynllunio | Monitro uwch ar gyfer ansawdd a pherfformiad, ymyrraeth wedi’i thargedu ar gyfer cyllid a chynllunio |
| Bwrdd Iechyd Addysgu Powys | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |
| Ymddiriedolaeth GIG Iechyd Cyhoeddus Cymru | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |
| Bwrdd Iechyd Prifysgol Bae Abertawe | Monitro uwch | Monitro uwch ar gyfer ansawdd a pherfformiad | Monitro uwch ar gyfer ansawdd a pherfformiad |
| Ymddiriedolaeth GIG Felindre | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |
| Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru | Trefniadau arferol | Trefniadau arferol | Trefniadau arferol |