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Following my recent statement, I am pleased to provide Members with a further update, about the progress of the Six Goals for Urgent and Emergency Care programme.


I launched the programme in April, as the NHS was emerging from a winter dominated by the coronavirus pandemic and emergency pressures. The NHS is continuing to work under intense pressure, as we see a fresh surge in coronavirus cases in the community and as staff work incredibly hard to provide planned care and reduce waiting times, which built up over the pandemic.


The Six Goals programme is supported by a £25m annual budget – this year, health boards and NHS trusts can access up to £20m. Each health board will have up to £2\.96m towards the delivery of their local programme plans and a £4m Six Goals for Urgent and Emergency Care Programme Innovation and Delivery Fund will be available for nationally\-coordinated projects.


Our key priorities for this year are to increase capacity in urgent primary care and same\-day emergency care services to help people access care closer to home without needing to visit an emergency department or be admitted to hospital. I have been encouraged by the early progress and the whole system transformation taking place through the programme. 


There are currently nine urgent primary care centres across Wales \- and a practice\-based approach in Powys \- with coverage spanning 256 practices, 39 clusters and a total population of 1\.8m people across Wales being able to be referred into these services.  The Programme team continues to work with health boards to expand the number of urgent primary care models available and I have been encouraged by the positive feedback received from staff and patients on the benefits of this approach.


All health boards have committed to expanding and extending same\-day emergency care services, through a mix of medical, surgical and community\-based models. Welsh Government funding has supported increased staffing and hours of operation, enabling more people to be assessed, undergo diagnostic tests and have treatment without being admitted to hospital or staying overnight.


In April, we issued national guidance to enable paramedics to make direct referrals to same\-day emergency care services. 


I expect health boards to accelerate the development and delivery of these same\-day services as we plan for winter. Welsh Government funding will enable Cardiff and Vale University Health Board to open its dedicated surgical same\-day emergency unit at the University Hospital of Wales later this month, and Aneurin Bevan University Health Board to open its dedicated same\-day emergency centre at the Grange University Hospital next month.


The roll out of the NHS 111 Wales telephone service is another important milestone and provides a consistent 24/7 free\-to\-access service to support people with urgent health needs across Wales. For many people, this will mean they have access to community services without attending an emergency department. More than 260,000 people have used the service since it became available nationally.   


The emergency ambulance service continues to be under pressure across Wales. We are investing an extra £3m to help the Welsh Ambulance Service increase its response capacity as quickly as possible through the recruitment of between 100\-150 frontline staff. This funding is in addition to £1\.8m of non\-recurrent funding from the Emergency Ambulance Services Committee earlier this year to continue support from St John Ambulance Cymru and provide other additional capacity to meet demand.


The Emergency Ambulance Services Committee is working with health boards and the Welsh Ambulance Services Trust to develop a refreshed and enhanced integrated improvement plan for ambulance services.  I expect it to include a clear focus on joint actions to improve response times and reduce ambulance patient handover delays at hospitals, as well as better managing people in the community.


Ambulance handover improvement plans have been developed for each emergency department in Wales. We have started to see improvement in handover performance in some areas – further improvement will not only free up ambulances to respond to urgent calls in the community, it will also improve patient experience and outcomes.


Finally, all health boards have committed to work with Local Authorities and partners to create additional community care beds – or their equivalents – by October to improve flow through the health and care system. The work is being supported by the Six Goals team and a renewed focus on a discharge to recover then assess (D2RA) model. It will support people to return home or to their local communities when ready and improve timeliness of care in other parts of the urgent and emergency care system.


I have given health board leaders the challenge to establish an additional 1,000 bed spaces or their equivalents to support people who have become “stuck” in hospital because of the lack of capacity in D2RA services, social and community care. This is the first element of our enhanced winter planning approach, which will be supported by our continued commitment to Six Goals priorities.


I will provide a further update about progress in the autumn.







Translation:


 
Yn dilyn fy natganiad diweddar, mae’n bleser gennyf rannu diweddariad pellach â’r Aelodau ynglŷn â chynnydd y rhaglen Chwe Nod ar gyfer Gofal Brys a Gofal mewn Argyfwng.


Lansiais y rhaglen ym mis Ebrill wedi i’r GIG gael gaeaf a oedd wedi’i ddominyddu gan bandemig y coronafeirws a phwysau argyfwng. Mae’r GIG yn parhau i weithio o dan bwysau sylweddol, a hynny wrth inni weld ymchwydd newydd mewn achosion o’r coronafeirws yn y gymuned. Yn ogystal, mae staff yn gweithio’n eithriadol o galed i ddarparu gofal a gynlluniwyd a lleihau amseroedd aros a gronnodd yn ystod y pandemig.


Mae’r rhaglen Chwe Nod yn cael ei chefnogi gan gyllideb flynyddol o £25m, ac eleni, gall byrddau iechyd ac ymddiriedolaethau y GIG gael gafael ar hyd at £20m. Bydd pob bwrdd iechyd yn cael hyd at £2\.96m tuag at gyflawni eu cynlluniau rhaglenni lleol a bydd Cronfa Arloesi a Chyflawni’r Chwe Nod ar gyfer Gofal Brys a Gofal mewn Argyfwng gwerth £4m ar gael ar gyfer prosiectau sy’n cael eu cydlynu’n genedlaethol.


Ein prif flaenoriaethau ar gyfer y flwyddyn hon yw cynyddu capasiti o fewn gwasanaethau gofal sylfaenol brys a gwasanaethau gofal mewn argyfwng ar yr un diwrnod er mwyn helpu pobl i gael gafael ar ofal yn agosach i gartref heb fod angen iddynt ymweld ag adran achosion brys neu gael eu derbyn i’r ysbyty. Rwyf wedi fy nghalonogi gan y cynnydd cynnar sydd wedi’i gyflawni, yn ogystal â’r gwaith sy’n mynd rhagddo drwy’r rhaglen i drawsnewid y system gyfan.


Ar hyn o bryd, mae naw canolfan gofal sylfaenol brys ledled Cymru, a dull o weithio sy’n seiliedig ar ymarfer ym Mhowys, Mae’r gwasanaethau yn cwmpasu 256 o bractisau, 39 o glystyrau a chyfanswm poblogaeth o 1\.8m o bobl ledled Cymru sy’n gallu cael eu hatgyfeirio at y gwasanaethau hyn. Mae tîm y Rhaglen yn parhau i weithio gyda byrddau iechyd i ehangu’r nifer o fodelau gofal sylfaenol brys sydd ar gael ac rwyf wedi fy nghalonogi gan yr adborth cadarnhaol a gafwyd gan staff a chleifion ynghylch manteision y dull hwn o weithio.


Mae’r holl fyrddau iechyd wedi ymrwymo i ehangu ac ymestyn gwasanaethau gofal mewn argyfwng ar yr un diwrnod drwy gyfuniad o fodelau meddygol, modelau llawfeddygol a


modelau sydd wedi’u seilio yn y gymuned. Mae cyllid gan Lywodraeth Cymru wedi cefnogi cynnydd mewn lefelau staffio a chynnydd yn oriau gweithredu’r gwasanaethau hyn. Mae hyn yn galluogi mwy o bobl i gael eu hasesu, cael profion diagnostig a chael triniaeth heb gael eu derbyn i’r ysbyty neu aros yno dros nos.


Ym mis Ebrill, cyhoeddwyd canllawiau cenedlaethol gennym er mwyn galluogi parafeddygon i wneud atgyfeiriadau uniongyrchol at wasanaethau gofal mewn argyfwng ar yr un diwrnod.


Disgwyliaf i fyrddau iechyd gyflymu’r gwaith o ddatblygu a chyflawni’r gwasanaethau gofal mewn argyfwng ar yr un diwrnod hyn wrth inni gynllunio at y gaeaf. Bydd cyllid gan Lywodraeth Cymru yn galluogi Bwrdd Iechyd Prifysgol Caerdydd a’r Fro i agor ei uned lawfeddygol bwrpasol gofal mewn argyfwng ar yr un diwrnod yn Ysbyty Athrofaol Cymru yn ddiweddarach y mis hwn. Bydd y cyllid hefyd yn galluogi Bwrdd Iechyd Prifysgol Aneurin Bevan i agor ei ganolfan bwrpasol gofal mewn argyfwng ar yr un diwrnod yn Ysbyty Athrofaol y Faenor fis nesaf.


Mae rhoi gwasanaeth ffôn GIG 111 Cymru ar waith yn garreg filltir bwysig arall. Mae’r gwasanaeth hwn yn sicrhau gwasanaeth cyson am ddim 24/7 i gefnogi pobl sydd ag anghenion iechyd brys ledled Cymru. I lawer o bobl, bydd hyn yn golygu eu bod yn gallu cael gafael ar wasanaethau yn y gymuned heb orfod mynd i adran achosion brys. Ers i’r gwasanaeth ddod yn weithredol yn genedlaethol, mae dros 260,000 o bobl wedi’i ddefnyddio.


Mae’r gwasanaeth ambiwlans brys yn parhau i fod o dan bwysau ledled Cymru. Rydym yn buddsoddi £3m ychwanegol er mwyn cynorthwyo Gwasanaeth Ambiwlans Cymru i gynyddu capasiti ymateb y gwasanaeth mor fuan â phosibl drwy broses o benodi rhwng 100 a 150 o weithwyr rheng flaen. Mae’r cyllid hwn yn ychwanegol i’r £1\.8m o gyllid unigol a roddwyd yn gynharach eleni gan y Pwyllgor Gwasanaethau Ambiwlans Brys er mwyn parhau â chefnogaeth Ambiwlans Sant Ioan Cymru, yn ogystal â sicrhau capasiti ychwanegol arall er mwyn ateb y galw.


Mae’r Pwyllgor Gwasanaethau Ambiwlans Brys yn gweithio gyda byrddau iechyd ac Ymddiriedolaeth Gwasanaethau Ambiwlans Cymru i ddatblygu cynllun gwella integredig wedi’i adnewyddu a’i wella ar gyfer gwasanaethau ambiwlans. Disgwyliaf i’r cynllun hwn gynnwys ffocws clir ar gamau gweithredu ar y cyd er mwyn gwella amseroedd ymateb, lleihau oedi wrth drosglwyddo cleifion o ambiwlansys, yn ogystal â delio yn well â phobl yn y gymuned.


Mae cynlluniau gwella o ran symud cleifion o ambiwlansys wedi’u datblygu ar gyfer pob adran achosion brys yng Nghymru. Rydym wedi dechrau gweld gwelliant ym mherfformiad trosglwyddo cleifion o ambiwlansys mewn rhai ardaloedd. Nid yn unig y bydd gwelliant pellach yn rhyddhau ambiwlansys i ymateb i alwadau brys yn y gymuned ond bydd hyn hefyd yn gwella profiadau cleifion ac yn gwella canlyniadau iddynt.


I gloi, mae pob bwrdd iechyd wedi ymrwymo i weithio gydag Awdurdodau Lleol a phartneriaid i sicrhau gwelyau gofal cymunedol ychwanegol \- neu’r hyn sy’n cyfateb iddynt \- erbyn mis Hydref er mwyn gwella llif cleifion drwy’r system iechyd a’r system gofal. Caiff y gwaith hwn ei gefnogi gan y tîm Chwe Nod yn ogystal â ffocws o’r newydd ar fodel rhyddhau i adfer yna asesu (D2RA). Bydd hyn yn cefnogi pobl i ddychwelyd adref neu ddychwelyd i’w cymunedau lleol pan fyddant yn barod ac yn gwella prydlondeb gofal mewn rhannau eraill o’r system gofal brys a gofal mewn argyfwng.


Rwyf wedi gosod her i arweinwyr y byrddau iechyd i sicrhau 1000 o fannau gwely ychwanegol, neu’r hyn sy’n cyfateb iddynt, er mwyn cefnogi pobl sy’n parhau i orfod aros yn yr ysbyty o ganlyniad i’r diffyg capasiti o fewn gwasanaethau rhyddhau i adfer yna asesu, gwasanaethau gofal cymdeithasol a gwasanaethau gofal cymunedol. Dyma’r elfen gyntaf yn ein dull gwell o weithio o ran cynllunio at y gaeaf. Bydd y gwaith hwn yn cael ei gefnogi gan ein hymrwymiad parhaus tuag at flaenoriaethau’r Chwe Nod.


Byddaf yn rhoi diweddariad pellach ynglŷn â chynnydd y rhaglen yn nhymor yr hydref.