Translate the text from English to Welsh.



 
In January 2018, I made a statement to members regarding the diagnosis, treatment and care of people in a permanent vegetative or minimally conscious state. 


Subsequently, the legal position regarding the withdrawal of clinically assisted nutrition and hydration (CANH) was clarified via a Supreme Court Decision in July 2018\. The court ruled that judicial approval will no longer be required discontinuing life\-prolonging treatment, for individuals with a prolonged disorder of consciousness (PDOC), which includes both a permanent vegetative state (PVS) and a minimally conscious state (MCS), provided that there is agreement upon what is in the best interests of the patient, the provisions of the Mental Capacity Act 2005 have been followed, and the relevant professional guidance has been observed.


Professor Baroness Finlay of Llandaff, former clinical palliative care lead for Wales and current chair of the National Mental Capacity Forum for England and Wales, has led a review of decision making within an individual case previously drawn to my attention. 


I am pleased to note the report found the care, attention and behaviours provided by staff during this case were of an extremely high level. However, there are areas of treatment and guidance that require further consideration to ensure the best possible care is being provided to every patient in Wales and their families. A copy of the report can be found here: https://gov.wales/topics/health/publications/health/reports/permanent\-vegetative\-or\-minimal\-conscious\-states/?skip\=1\&lang\=en


Concurrently, I requested a task and finish group be convened to consider whether there is a need for any additional guidance, education or training to be developed for the health and social care sector in Wales. 


Baroness Finlay’s review made a number of detailed recommendations which were considered by the task and finish group and are in line with its recommendations. 


Having reflected on the recommendations, it seems clear there are certain difficulties with identifying individuals due to the nature of the injuries sustained and the range of setting where ongoing care may be provided. 


I have therefore requested Welsh Health Specialised Services Committee work with health boards in Wales to undertake a needs assessment, develop appropriate pathways and ensure services are organised appropriately this includes the provision of information for families and healthcare professionals.


As part of this health boards will need to consider guidance for non\-specialist staff to help identifying individuals presenting these conditions, reflect on the training provided to health and social care professionals to help recognise these conditions, which are often difficult to initially diagnose, as well ensuring individuals and their families receive the level of care they require. 


I would like to thank Baroness Finlay, the members of the task and finish group and everyone who has contributed to this important piece of work. I would also like to thank all members of the NHS and social care that work in this area, often having to hold extremely difficult conversations and doing so with professionalism and compassion on a daily basis. 


I want this work to be the beginning of ensuring all individuals in Wales who may be or are in a prolonged disorder of consciousness receive equitable treatment and families are supported during an extremely difficult time.  







Translation:


 
Ym mis Ionawr 2018, cyhoeddais ddatganiad i'r aelodau ynghylch diagnosis, triniaeth a gofal i bobl sydd mewn cyflwr diymateb parhaol neu gyflwr lled\-anymwybodol. 


Yn dilyn hynny, cafwyd eglurder ar y sefyllfa gyfreithiol ynghylch rhoi’r gorau i roi maeth a hydradiad gyda chymorth clinigol drwy Benderfyniad y Goruchaf Lys ym mis Gorffennaf 2018\. Dyfarnodd y llys na fydd angen cymeradwyaeth farnwrol bellach er mwyn rhoi'r gorau i driniaeth sy'n ymestyn bywyd unigolion ag anhwylder ymwybyddiaeth cyfnod estynedig, sy'n cynnwys cyflwr diymateb parhaol a chyflwr lled\-anymwybodol, ar yr amod bod cytundeb ynghylch yr hyn sydd er budd y claf, bod darpariaethau Deddf Galluedd Meddyliol 2005 wedi'u dilyn a bod y canllawiau proffesiynol perthnasol wedi cael sylw. 


Mae'r Farwnes Finlay o Landaf, cyn arweinydd gofal lliniarol clinigol Cymru a chadeirydd presennol Fforwm Galluedd Meddyliol Cymru a Lloegr, wedi arwain adolygiad o benderfyniadau o fewn achos unigol a dynnwyd at fy sylw yn flaenorol.  


Rwy'n falch o nodi i'r adroddiad ganfod bod y gofal, y sylw a'r ymddygiadau gan staff yn ystod yr achos hwn o lefel uchel tu hwnt. Fodd bynnag, mae meysydd eraill o driniaeth a chanllawiau sydd angen ystyriaeth bellach er mwyn sicrhau bod y gofal gorau posib yn cael ei ddarparu i bob claf yng Nghymru a'u teuluoedd. Ceir copi o'r adroddiad yma: https://gov.wales/topics/health/publications/health/reports/permanent\-vegetative\-or\-minimal\-conscious\-states/?skip\=1\&lang\=cy


Ar yr un pryd, gofynnais am alw grŵp gorchwyl a gorffen ynghyd i ystyried a oes angen datblygu rhagor o ganllawiau, addysg neu hyfforddiant ar gyfer y sector iechyd a gofal cymdeithasol yng Nghymru. 


Roedd adolygiad y Farwnes Finlay yn gwneud nifer o argymhellion manwl a ystyriwyd gan y grŵp gorchwyl a gorffen ac sydd yn gyson â'i argymhellion. 


Wedi ystyried yr argymhellion, mae'n amlwg bod rhai anawsterau’n codi o ran adnabod unigolion yn sgil natur yr anafiadau a ddioddefwyd a'r amrywiaeth o leoliadau lle gall gofal parhaus gael ei ddarparu. 


Rwyf felly wedi gofyn i Bwyllgor Gwasanaethau Iechyd Arbenigol Cymru weithio gyda byrddau iechyd Cymru i gynnal asesiad o anghenion, datblygu llwybrau priodol a sicrhau bod gwasanaethau'n cael eu trefnu'n briodol. Mae hyn yn cynnwys darparu gwybodaeth i deuluoedd a gweithwyr gofal iechyd proffesiynol. 


Fel rhan o hyn, bydd angen i fyrddau iechyd ystyried canllawiau i staff anarbenigol er mwyn helpu i adnabod unigolion sydd â'r cyflyrau hyn, ystyried yr hyfforddiant a roddir i weithwyr proffesiynol ym meysydd iechyd a gofal cymdeithasol i adnabod y cyflyrau hyn, sy'n aml yn anodd rhoi diagnosis iddynt, a sicrhau bod unigolion a'u teuluoedd yn cael y lefel o ofal sy'n ofynnol. 


Hoffwn ddiolch i'r Farwnes Finlay, aelodau'r grŵp gorchwyl a gorffen a phawb sydd wedi cyfrannu tuag at y darn pwysig hwn o waith. Hoffwn hefyd ddiolch i holl aelodau'r GIG a gofal cymdeithasol sy'n gweithio yn y maes hwn, sy'n aml yn gorfod cael sgyrsiau anodd tu hwnt ac yn gwneud hynny mewn ffordd broffesiynol a charedig o ddydd i ddydd. 


Rwyf am i'r gwaith hwn fod yn gam cyntaf er mwyn sicrhau bod pob un o'r unigolion yng Nghymru sydd o bosib neu'n bendant yn dioddef anhwylder ymwybyddiaeth cyfnod estynedig yn cael triniaeth deg, a'u teuluoedd yn cael cefnogaeth ar adeg aruthrol o anodd.