Translate the text from English to Welsh.



 
Under the Joint Escalation and Intervention Arrangements, Welsh Government officials meet with Audit Wales and Healthcare Inspectorate Wales at least twice a year to discuss the overall position of each health board, NHS trust and Special Health Authority in respect of quality, governance, service performance and financial management.  A wide range of information and intelligence is considered to identify any issues and inform the assessment.


The framework has four escalation levels:


* Routine arrangements
* Enhanced monitoring
* Targeted intervention
* Special measures.


The latest meeting took place virtually on 7 September 2022\.  Betsi Cadwaladr UHB and Cwm Taf Morgannwg UHB were not considered in this meeting – their escalation status will be discussed in a meeting later in October 2022\.  


The group noted organisations continue to struggle in relation to performance, particularly urgent and emergency care, planned care recovery and cancer, noting the impact this was having on quality of care and patient experience.


Following the meeting, the Chief Executive of NHS Wales made the following recommendations to me:


* Escalate Cardiff and Vale UHB from routine arrangements to enhanced monitoring for planning and finance,
* Escalate Hywel Dda UHB to targeted intervention for planning and finance and for them to remain in enhanced monitoring for quality and performance.
* De\-escalate Swansea Bay UHB to routine arrangements for planning and finance, but for it to remain in enhanced monitoring for quality and performance.


I have accepted these recommendations for the following reasons:


Cardiff and Vale UHB has been escalated to enhanced monitoring from routine arrangements because it was unable to submit a balanced and approvable three\-year Integrated Medium Term Plan (IMTP). The health board is aware of the requirements and is working to address the position. This status will be reviewed at the next meeting.


Hywel Dda UHB has been escalated to targeted intervention from enhanced monitoring for finance and planning because it has been unable to submit a balanced and approvable IMTP or a finalised annual plan and a growing financial deficit is being reported.  On quality and performance, there are concerns around urgent and emergency care, including ambulance handover, cancer and performance against part 1a of the child and adolescent mental health services (CAMHS) measure.


Swansea Bay UHB has been de\-escalated to routine arrangements from enhanced monitoring for finance and planning as it has an approved IMTP. The health board will remain in enhanced monitoring for quality and performance as concerns remain around the speed of the restart of planned care, cancer and daily fluctuations in urgent and emergency care.


All other organisations remained at their previous level of escalation.


The table at annex 1 shows the previous and current escalation status of each organisation.


Annex 1




| **Organisation** | **Previous Status**  **(Feb 22\)** | **Current Status**  **(Sept 22\)** |
| --- | --- | --- |
| Aneurin Bevan UHB | 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, |
| Cardiff and Vale UHB | Routine arrangements | Enhanced monitoring for planning and finance |
| Cwm Taf Morgannwg UHB | Special measures for maternity, targeted intervention for quality and governance | Special measures for maternity, targeted intervention for quality and governance |
| Digital Health and Care Wales | Routine arrangements | Routine arrangements |
| Health Education and Improvement Wales | Routine arrangements | Routine arrangements |
| Hywel Dda UHB | Enhanced monitoring | Enhanced monitoring for quality and performance, targeted intervention for finance and planning |
| Powys tHB | Routine arrangements | Routine arrangements |
| Public Health Wales NHS Trust | Routine arrangements | Routine arrangements |
| Swansea Bay UHB | Enhanced monitoring | Enhanced monitoring for quality and performance |
| Velindre NHS Trust | Routine arrangements | Routine arrangements |
| Welsh Ambulance Services NHS Trust | Routine arrangements | Routine arrangements |







Translation:


 
O dan y Cyd\-drefniadau Uwchgyfeirio ac Ymyrryd, mae swyddogion Llywodraeth Cymru’n cyfarfod ag Archwilio Cymru ac Arolygiaeth Gofal Iechyd Cymru o leiaf ddwywaith y flwyddyn i drafod sefyllfa gyffredinol pob un o’r byrddau iechyd, ymddiriedolaethau’r GIG a’r Awdurdodau Iechyd Arbennig mewn perthynas ag ansawdd, llywodraethu, perfformiad gwasanaethau a rheolaeth ariannol. Mae amrywiaeth eang o wybodaeth yn cael ei hystyried er mwyn nodi unrhyw faterion a llywio’r asesiad.


Mae pedair lefel uwchgyfeirio yn y fframwaith:


* Trefniadau arferol
* Monitro uwch
* Ymyrraeth wedi'i thargedu
* Mesurau arbennig


Cynhaliwyd y cyfarfod diweddaraf yn rhithiol ar 7 Medi 2022\. Ni chafodd Bwrdd Iechyd Prifysgol Betsi Cadwaladr na Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg eu hystyried yn y cyfarfod hwn – bydd eu statws uwchgyfeirio yn cael ei drafod mewn cyfarfod diweddarach ym mis Hydref 2022\.


Nododd y grŵp fod sefydliadau yn parhau i gael anawsterau o ran perfformiad, yn arbennig gofal brys ac argyfwng, adfer ar gyfer gofal a gynlluniwyd a chanser, gan nodi’r effaith roedd hyn yn ei chael ar ansawdd y gofal a phrofiad cleifion.


Yn dilyn y cyfarfod, gwnaeth Prif Weithredwr GIG Cymru yr argymhellion a ganlyn imi:


* Uwchgyfeirio Bwrdd Iechyd Prifysgol Caerdydd a’r Fro o’r lefel trefniadau arferol at y lefel monitro uwch ar gyfer cynllunio a chyllid.
* Uwchgyfeirio Bwrdd Iechyd Prifysgol Hywel Dda at y lefel ymyrraeth wedi’i thargedu ar gyfer cynllunio a chyllid ac iddo barhau ar y lefel monitro uwch ar gyfer ansawdd a pherfformiad.
* Isgyfeirio Bwrdd Iechyd Prifysgol Bae Abertawe at y lefel trefniadau arferol ar gyfer cynllunio a chyllid, ond iddo barhau ar y lefel monitro uwch ar gyfer ansawdd a pherfformiad.


Rwyf wedi cytuno i’r argymhellion hyn am y rhesymau canlynol:


Mae Bwrdd Iechyd Prifysgol Caerdydd a’r Fro wedi cael ei uwchgyfeirio at y lefel monitro uwch o’r lefel trefniadau arferol oherwydd nad oedd yn gallu cyflwyno Cynllun Tymor Canolig Integredig tair blynedd cytbwys a chymeradwy. Mae’r bwrdd iechyd yn ymwybodol o’r gofynion ac mae’n gweithio i fynd i’r afael â’r sefyllfa. Bydd y statws hwn yn cael ei adolygu yn y cyfarfod nesaf.


Mae Bwrdd Iechyd Prifysgol Hywel Dda wedi cael ei uwchgyfeirio at y lefel ymyrraeth wedi’i thargedu o’r lefel monitro uwch ar gyfer cyllid a chynllunio oherwydd nad oedd yn gallu cyflwyno Cynllun Tymor Canolig Integredig cytbwys a chymeradwy neu gynllun blynyddol terfynol ac mae diffyg ariannol cynyddol yn cael ei adrodd. O ran ansawdd a pherfformiad, mae yna bryderon ynghylch gofal brys ac argyfwng, gan gynnwys trosglwyddo cleifion o ambiwlans, canser a pherfformiad yn erbyn rhan 1a o’r mesur gwasanaethau iechyd meddwl plant a’r glasoed.


Mae Bwrdd Iechyd Prifysgol Bae Abertawe wedi cael ei isgyfeirio at y lefel trefniadau arferol o’r lefel monitro uwch ar gyfer cyllid a chynllunio oherwydd bod ganddo Gynllun Tymor Canolig Integredig cymeradwy. Bydd y bwrdd iechyd yn parhau ar y lefel monitro uwch ar gyfer ansawdd a pherfformiad gan fod pryderon yn parhau ynghylch cyflymder ailddechrau gofal a gynlluniwyd, canser ac amrywiadau dyddiol mewn gofal brys ac argyfwng.


Mae pob sefydliad arall yn parhau i fod ar eu lefel uwchgyfeirio flaenorol.


Dengys y tabl yn Atodiad 1 statws uwchgyfeirio blaenorol a phresennol pob sefydliad.


Atodiad 1




| **Sefydliad** | **Statws Blaenorol** **(Chwefror 22\)** | **Statws Presennol**  **(Medi 22\)** |
| --- | --- | --- |
| Bwrdd Iechyd Prifysgol Aneurin Bevan | 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 |
| Bwrdd Iechyd Prifysgol Caerdydd a'r Fro | Trefniadau arferol | Monitro uwch ar gyfer cynllunio a chyllid |
| Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg | Mesurau arbennig ar gyfer mamolaeth, ymyrraeth wedi'i thargedu ar gyfer ansawdd a llywodraethu | Mesurau arbennig ar gyfer mamolaeth, ymyrraeth wedi'i thargedu ar gyfer ansawdd a llywodraethu |
| Iechyd a Gofal Digidol Cymru | Trefniadau arferol | Trefniadau arferol |
| Addysg a Gwella Iechyd Cymru | 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 |
| Bwrdd Iechyd Addysgu Powys | Trefniadau arferol | Trefniadau arferol |
| Ymddiriedolaeth GIG Iechyd Cyhoeddus Cymru | Trefniadau arferol | Trefniadau arferol |
| Bwrdd Iechyd Prifysgol Bae Abertawe | Monitro uwch | Monitro uwch ar gyfer ansawdd a pherfformiad |
| Ymddiriedolaeth GIG Felindre | Trefniadau arferol | Trefniadau arferol |
| Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru | Trefniadau arferol | Trefniadau arferol |