Translate the text from English to Welsh.



 
 


Members will be aware of my intention to commission an external independent review into the care provided at the Princess of Wales Hospital, Bridgend and Neath Port Talbot Hospital. I would like to update Members on the arrangements for this review.


The Health Board is already taking a range of actions to ensure the delivery of safe and high quality care to patients at the Princess of Wales Hospital. Progress is being monitored by the Chief Medical Officer and the Chief Nursing Officer. As a part of these actions an external quality and safety review has been commissioned by the Health Board.


However, I felt there was also a need for an additional independent review focusing on the care of older patients at two hospitals, following a meeting with a family who described their experiences in relation to the care of their elderly relative. The independent external review will consider the care provided at the Princess of Wales Hospital and Neath Port Talbot Hospital and will be in addition to the review already commissioned by the Health Board.


Using an established ‘deep dive’ review methodology, the scope of the work will cover provision directly related to the care of older people focusing in more detail on the specific areas:


 


* how professional nursing standards are protected and delivered consistently, and determine how the Health Board responds to lapses in delivery of these standards;
* the culture of care, particularly focussing on the care of older patients in the medical wards;
* responding to complaints, particularly looking at how complaints are handled by the Health Board and how professionals are held to account for lapses in care identified through investigation of complaints (including POVA investigations); and,
* administration and recording of medicines, particularly looking at how medicines are administered to patients who are cognitively impaired or have other challenges in taking medicines orally.


 


I am pleased to confirm that Professor June Andrews, Director of the Dementia Services Development Centre (DSDC) in the School of Applied Social Science at the University of Stirling, Scotland has agreed to lead this review.


Professor Andrews is a world leading expert in the care of people with dementia and has broad experience in the NHS being a past nurse executive director, has worked as a Senior Civil Servant in the Scottish Government, she was Board Secretary of the Royal College of Nursing (Scotland) and in 2012 was given a lifetime achievement award by the four Chief Nursing Officers of the UK for her work in dementia care improvement. She is internationally recognised for her contribution to continuous improvement in health and social care systems.


The review will commence in December and continue into early next year. The review’s findings, together with recommendations, will be made publically available.


The full terms of reference for the review are set out in annex 1\. 


 


 


 


 


 


 


 


**Annex 1**


**“Deep Dive” review of practice in ABM University Health Board**


**1\. Purpose and Scope**  

The review to be conducted by University of Stirling Dementia Services Development Centre (DSDC) will provide an independent assessment of the current strategies and provision related to the care of older people, including those with dementia, within Princess of Wales Hospital, Bridgend and Neath Port Talbot Hospital and to provide a report on fitness for purpose in relation to relevant evidence\-based standards.


The focus will be on identifying key areas of strength, which can be built upon, and areas of potential risk, where further action might be recommended.  


The scope of the work will cover provision directly related to the care of older people at the Princess of Wales Hospital, Bridgend and Neath Port Talbot Hospital focusing in more detail on the specific areas below:


 


* how professional nursing standards are protected and delivered consistently, and how the Health Board responds to lapses in delivery of these standards;
* the culture of care, particularly focussing on the care of older patients in the medical wards;
* responding to complaints, particularly looking at how complaints are handled by the Health Board and how professionals are held to account for lapses in care identified through investigation of complaints (including POVA investigations); and,
* administration and recording of medicines, particularly looking at how medicines are administered to patients who are cognitively impaired or have other challenges in taking medicines orally.


 


The focus is on two of the hospitals of the ABM University Health Board: Princess of Wales Hospital, Bridgend  and Neath Port Talbot Hospital.


  

**2\. Methodology and Timing**  

The “deep dive” uses an established methodology which has been developed over a period of years by DSDC. A Case Study on one of the “deep dives” can be found here http://www.dementia.stir.ac.uk/case\-studies/04\-change\-deep\-dive


The approach deliberately looks at strategic and practical issues together. The “deep dive” is normally conducted intensively over a short period of time.  In part it deliberately follows the direct experience of people using the service and their carers through services and pathways from admission onwards.  The methodology involves direct engagement with staff at all key points on this process, thus allowing important changes to be worked through with front\-line staff at the time and unlocking immediate changes of demonstrable benefit in priority areas, based on evidence of what is known to work.


During the deep dive activity, specific areas of practice or policy will be identified to be part of the ‘look back’ exercise. The ‘look back’ will help identify how practices have evolved and where further change is advisable to improve standards of care.  

The assessment will be undertaken from December 2013, through the early part of 2014  to include the following elements:


 


* review of key documents and data
* structured interviews with key stakeholders
* sample visits to service providers and partners


The assessment will be undertaken by two named individuals who have led other Deep Dives in the last two years:


 


 


* Professor June Andrews, Director of Dementia Services Development Centre, University of Stirling
* Mark Butler, Director of Development (DSDC) and Director, The People Organisation Ltd


Professor Andrews and Mark Butler will be assisted by the Director of Learning and Development of the DSDC, Shirley Law.  Expert contextual advice on the Welsh NHS will be obtained from an independent named associate from Wales to support the reviewers from outwith the Health Board. 


 







Translation:


 
Bydd Aelodau’n gwybod am fy mwriad i gomisiynu adolygiad annibynnol allanol i’r gofal a ddarperir yn Ysbyty Tywysoges Cymru, Pen\-y\-bont ac Ysbyty Castell Nedd Port Talbot . Hoffwn roi diweddariad i Aelodau am drefniadau’r adolygiad hwn.

Mae’r Bwrdd Iechyd eisoes yn cymryd nifer o gamau i sicrhau bod gofal diogel o ansawdd uchel yn cael ei gyflenwi i gleifion yn Ysbyty Tywysoges Cymru. Mae cynnydd yn cael ei fonitro gan y Prif Swyddog Meddygol a’r Prif Swyddog Nyrsio. Fel rhan o’r gweithredu hwn mae adolygiad allanol o ansawdd a diogelwch wedi’i gomisiynu gan y Bwrdd Iechyd.

Fodd bynnag, roeddwn i’n teimlo bod angen adolygiad annibynnol ychwanegol hefyd yn canolbwyntio ar ofal cleifion hŷn mewn dau ysbyty, yn dilyn cyfarfod gyda theulu a ddisgrifiodd eu profiadau gyda gofal eu perthynas oedrannus. Bydd yr adolygiad allanol annibynnol yn ystyried y gofal a ddarperir yn Ysbyty Tywysoges Cymru ac Ysbyty Castell Nedd Port Talbot a bydd yn ychwanegol i’r adolygiad sydd eisoes wedi’i gomisiynu gan y Bwrdd Iechyd. Gan ddefnyddio methodoleg adolygu sefydledig fydd yn mynd at wraidd y sefyllfa, bydd y gwaith yn cwmpasu darpariaeth sy’n ymwneud yn uniongyrchol â gofal i bobl hŷn, gan ganolbwyntio’n fwy manwl ar y meysydd penodol:

* sut y caiff safonau nyrsio proffesiynol eu diogelu a’u cyflenwi’n gyson, a phennu sut mae’r Bwrdd Iechyd yn ymateb i ddiffygion wrth gyflawni’r safonau hyn;
* y diwylliant gofal, gan ganolbwyntio’n benodol ar ofal cleifion hŷn yn y wardiau meddygol;
* ymateb i gwynion, gan edrych yn benodol ar sut y caiff cwynion eu trin gan y Bwrdd Iechyd a sut y caiff gweithwyr proffesiynol eu dal yn atebol am ddiffygion gofal a ganfuwyd drwy ymchwilio i gwynion (gan gynnwys ymchwiliadau Amddiffyn Oedolion Agored i Niwed); a
* gweinyddu a chofnodi meddyginiaethau, gan edrych yn benodol ar sut y caiff meddyginiaethau eu rhoi i gleifion sydd â nam gwybyddol neu sy’n wynebu heriau eraill wrth lyncu meddyginiaeth.

Rwyf i’n falch i gadarnhau bod yr Athro June Andrews, Cyfarwyddwr y Ganolfan Datblygu Gwasanaethau Dementia (DSDC) yn Ysgol Gwyddor Gymdeithasol Gymwysedig Prifysgol Stirling, yr Alban, wedi cytuno i arwain yr adolygiad hwn.

Mae’r Athro Andrews yn arbenigwr blaenllaw drwy’r byd mewn gofal i bobl â dementia ac mae ganddi brofiad eang yn y GIG gan iddi fod yn gyfarwyddwr nyrsio gweithredol yn y gorffennol, bu’n gweithio fel Uwch Was Sifil yn Llywodraeth yr Alban, bu’n Ysgrifennydd Bwrdd y Coleg Nyrsio Brenhinol (yr Alban) ac yn 2012 dyfarnwyd iddi wobr cyflawniad oes gan bedwar Prif Swyddog Nyrsio’r DU am ei gwaith yn gwella gofal dementia. Caiff ei chydnabod yn rhyngwladol am ei chyfraniad at welliannau parhaus mewn systemau iechyd a gofal cymdeithasol.

Bydd yr adolygiad yn dechrau ym mis Rhagfyr ac yn parhau i mewn i ddechrau’r flwyddyn nesaf. Bydd canfyddiadau’r adolygiad, ynghyd ag argymhellion, ar gael i’r cyhoedd.

Mae cylch gorchwyl llawn yr adolygiad i’w weld yn atodiad 1\.

  


Atodiad 1

Adolygiad i fynd at wraidd ymarfer (“Deep Dive”) ym Mwrdd Iechyd Prifysgol ABM

1\. Diben a Chwmpas  
Bydd yr adolygiad, sydd i’w gynnal gan Ganolfan Datblygu Gwasanaethau Dementia (DSDC) Prifysgol Stirling, yn cynnig asesiad annibynnol o’r strategaethau a’r ddarpariaeth gyfredol mewn perthynas â gofal pobl hŷn, gan gynnwys y rheini â dementia, yn Ysbyty Tywysoges Cymru, Pen\-y\-bont ac Ysbyty Castell Nedd Port Talbot ac yn darparu adroddiad ar addasrwydd i’r diben o ran safonau perthnasol yn seiliedig ar dystiolaeth.

Bydd yn canolbwyntio ar ganfod meysydd allweddol o gryfder, y gellir adeiladu arnynt, a meysydd o risg posibl, lle gellid argymell camau pellach.

Bydd cwmpas y gwaith yn cynnwys darpariaeth yn ymwneud yn uniongyrchol â gofal pobl hŷn yn Ysbyty Tywysoges Cymru, Pen\-y\-bont ac Ysbyty Castell Nedd Port Talbot, gan ganolbwyntio’n fanylach ar y meysydd penodol isod:

* sut y caiff safonau nyrsio proffesiynol eu diogelu a’u cyflenwi’n gyson, a sut mae’r Bwrdd Iechyd yn ymateb i ddiffygion wrth gyflawni’r safonau hyn;
* y diwylliant gofal, gan ganolbwyntio’n benodol ar ofal cleifion hŷn yn y wardiau meddygol;
* ymateb i gwynion, gan edrych yn benodol ar sut y caiff cwynion eu trin gan y Bwrdd Iechyd a sut y caiff gweithwyr proffesiynol eu dal yn atebol am ddiffygion gofal a ganfuwyd drwy ymchwilio i gwynion (gan gynnwys ymchwiliadau Amddiffyn Oedolion Agored i Niwed); a
* gweinyddu a chofnodi meddyginiaeth, gan edrych yn benodol ar sut y caiff meddyginiaethau eu rhoi i gleifion sydd â nam gwybyddol neu sy’n wynebu heriau eraill wrth lyncu meddyginiaeth.

Bydd yn canolbwyntio ar ddau ysbyty o fewn Bwrdd Iechyd Prifysgol ABM: Ysbyty Tywysoges Cymru, Pen\-y\-bont ac Ysbyty Castell Nedd Port Talbot.

2\. Methodoleg ac Amseru  
Mae’r dull “deep dive” yn defnyddio methodoleg sydd wedi’i sefydlu a’i datblygu dros gyfnod o flynyddoedd gan DSDC. Gellir gweld Astudiaeth Achos “deep dive” yma http://www.dementia.stir.ac.uk/case\-studies/04\-change\-deep\-dive 

Mae’r dull yn edrych yn fwriadol ar faterion strategol ac ymarferol gyda’i gilydd. Fel arfer caiff ei gynnal yn ddwys dros gyfnod byr o amser. Yn rhannol mae’n dilyn profiad uniongyrchol y bobl sy’n defnyddio’r gwasanaeth a’r bobl sy’n gofalu amdanynt drwy’r gwasanaethau a’r llwybrau, o’r adeg y cânt eu derbyn i gael gofal ymlaen. Mae’r fethodoleg yn cynnwys ymgysylltu’n uniongyrchol â staff ar bob pwynt allweddol yn y broses hon, gan ganiatáu gweithio ar newidiadau pwysig gyda staff llinell flaen yn y fan a’r lle a datgloi newidiadau fydd â budd gweladwy mewn meysydd blaenoriaeth ar unwaith, yn seiliedig ar dystiolaeth o’r hyn y gwyddys ei fod yn gweithio. Yn ystod y gweithgaredd adolygu manwl, bydd meysydd penodol o ymarfer neu bolisi yn cael eu dynodi i fod yn rhan o’r ymarfer ‘edrych yn ôl’. Bydd hyn yn helpu i ganfod sut mae arferion wedi esblygu, a mannau lle cynghorir cael rhagor o newid er mwyn gwella safonau gofal.

Caiff yr asesiad ei gynnal o fis Rhagfyr 2013 i mewn i ddechrau 2014 a bydd yn cynnwys yr elfennau canlynol:

* adolygiad o ddogfennau a data allweddol
* cyfweliadau strwythuredig gyda rhanddeiliaid allweddol
* ymweliadau sampl â darparwyr gwasanaeth a phartneriaid

Caiff yr asesiad ei gynnal gan ddau unigolyn a enwir sydd wedi arwain adolygiadau o’r fath yn ystod y ddwy flynedd ddiwethaf:* Yr Athro June Andrews, Cyfarwyddwr Canolfan Datblygu Gwasanaethau Dementia Prifysgol Stirling
* Mark Butler, Cyfarwyddwr Datblygu (DSDC) a Chyfarwyddwr, The People Organisation Ltd

Bydd yr Athro Andrews a Mark Butler yn cael cymorth Cyfarwyddwr Dysgu a Datblygu DSDC, Shirley Law. Bydd cyngor cyd\-destunol arbenigol ar GIG Cymru yn cael ei ddarparu gan gyswllt annibynnol enwebedig o Gymru i gynorthwyo’r adolygwyr o’r tu allan i’r Bwrdd Iechyd.