English: Diolch yn fawr. 'The Future Approach for Optometry Services in Wales', published in March, is ambitious and it's transformative, changing the way eye health services are delivered. Aligned to 'A Healthier Wales', and underpinned by the key principles of prudent healthcare, the approach supports our overall aims, which are: to improve access for citizens; to move delivery of services from secondary care to primary care in order to address the backlog in patient appointments and delay in follow-up appointments in hospitals; to reduce demand on hospitals and GPs; and to reform general ophthalmic service contracts. As Members know, waiting times are significant. Patient numbers waiting for their first hospital eye health appointment, and subsequent follow-up, continue to rise. This increasing demand remains a challenge not just across Wales, but across the United Kingdom and Europe as well. Ten per cent of outpatient appointments are for eye clinics and cataract surgery accounts for about 6 per cent of all surgery in the United Kingdom. Current capacity to provide specialist hospital eye services is extremely limited due to limitations on personnel. The Royal College of Ophthalmologists 2018 census reported that an extra 230 consultant posts were required across the UK to meet rising demand for services. So, unfortunately, a significant numbers of posts remain unfilled. I'm afraid that the completion of trained doctors each year is on average 74 across the UK. Therefore, there is a significant shortfall of trained doctors to fill current and future hospital posts. In Wales, thankfully, we have had an increasing number of people in primary care to add to the optometry workforce. So, by 31 December 2018, 875 practitioners were able to deliver NHS sight tests, and that's 34 more than in the previous year and a 19 per cent increase since December 2008. Further upskilling to enable optometrists to work at the top of their licence in their practices, with the appropriate equipment, means optometrists are in an ideal position to support hospitals to address demand and transform patient pathways. Over the past five years, increasing numbers of optometrists have gained additional higher qualifications in medical retina, glaucoma and independent prescribing. Optometrists with these higher qualifications can diagnose, manage and treat more patients in primary care, improving patients' access to care closer to home. This approach will significantly reduce the demand for a hospital opinion and intervention, and we know that is already reducing demands on GPs. Last year, the then Minister for health announced £4.8 million funding to develop and implement a national electronic patient record and an electronic referral system across primary and secondary eye health care. To support this digitisation, health boards received £3.5 million in additional funding to replace equipment that had come to the end of its life. Introduction of these new digital systems will help to address the demand problems in hospitals, through shared care and monitoring of stable patients within primary care, providing a better experience and improved outcomes for citizens. The digitisation fund and the shift in emphasis complements the patient pathways, implementing and delivering services seamlessly across the patient journey between primary and secondary care. This is a significant move, enabling optometry practices to be the first port of call in primary care for patients with an eye problem.
Welsh: Diolch yn fawr. Mae 'Gwasanaethau Optometreg ar gyfer y dyfodol yng Nghymru', a gyhoeddwyd ym mis Mawrth, yn uchelgeisiol ac mae'n drawsnewidiol, gan newid y ffordd mae gwasanaethau iechyd llygaid yn cael eu darparu. Wedi'i alinio â 'Cymru Iachach', ac wedi'i ategu gan egwyddorion allweddol gofal iechyd darbodus, mae'r dull yn cefnogi ein nodau cyffredinol, sef: gwella mynediad i ddinasyddion; symud gwasanaethau o ofal eilaidd i ofal sylfaenol er mwyn mynd i'r afael â'r ôl-groniad mewn apwyntiadau cleifion ac oedi mewn apwyntiadau dilynol mewn ysbytai; lleihau'r galw ar ysbytai a meddygon teulu; a diwygio contractau gwasanaeth offthalmig cyffredinol. Fel y gŵyr yr Aelodau, mae amseroedd aros yn sylweddol. Mae nifer y cleifion sy'n aros am eu hapwyntiad iechyd llygaid cyntaf yn yr ysbyty, ac apwyntiadau dilynol, yn parhau i godi. Mae'r galw cynyddol hwn yn parhau i fod yn her nid yn unig ledled Cymru, ond ar draws y Deyrnas Unedig ac Ewrop hefyd. Mae deg y cant o apwyntiadau cleifion allanol ar gyfer clinigau llygaid ac mae llawdriniaeth cataract yn cyfrif am tua 6 y cant o'r holl lawdriniaethau yn y Deyrnas Unedig. Mae'r capasiti presennol i ddarparu gwasanaethau llygaid arbenigol mewn ysbytai yn gyfyngedig iawn oherwydd cyfyngiadau ar bersonél. Nododd cyfrifiad Coleg Brenhinol yr Offthalmolegwyr 2018 fod angen 230 o swyddi meddygon ymgynghorol ychwanegol ledled y DU i ateb y galw cynyddol am wasanaethau. Felly, yn anffodus, mae nifer sylweddol o swyddi heb eu llenwi o hyd. Mae arnaf ofn mai'r nifer o feddygon sy'n cwblhau hyfforddiant bob blwyddyn ar gyfartaledd yw 74 ledled y DU. Felly, mae diffyg sylweddol o feddygon hyfforddedig i lenwi swyddi ysbyty presennol ac ar gyfer y dyfodol. Yng Nghymru, diolch byth, rydym wedi cael nifer cynyddol o bobl mewn gofal sylfaenol i ychwanegu at y gweithlu optometreg. Felly, erbyn 31 Rhagfyr 2018, roedd 875 o ymarferwyr yn gallu darparu profion golwg y GIG, ac mae hynny 34 yn fwy nag yn y flwyddyn flaenorol a chynnydd o 19 y cant ers mis Rhagfyr 2008. Mae uwchsgilio pellach i alluogi optometryddion i weithio ar frig eu trwydded yn eu practisau, gyda'r offer priodol, yn golygu bod optometryddion mewn sefyllfa ddelfrydol i gefnogi ysbytai i fynd i'r afael â'r galw a thrawsnewid llwybrau cleifion. Dros y pum mlynedd diwethaf, mae nifer cynyddol o optometryddion wedi ennill cymwysterau uwch ychwanegol mewn retina meddygol, glawcoma a rhagnodi annibynnol. Gall optometryddion sydd â'r cymwysterau uwch hyn roi diagnosis, rheoli a thrin mwy o gleifion mewn gofal sylfaenol, gan wella mynediad cleifion at ofal yn nes at adref. Bydd y dull hwn yn lleihau'r galw am farn ac ymyriad ysbyty yn sylweddol, a gwyddom fod hynny eisoes yn lleihau'r galw ar feddygon teulu. Y llynedd, cyhoeddodd y Gweinidog iechyd ar y pryd £4.8 miliwn o gyllid i ddatblygu a gweithredu cofnod cleifion electronig cenedlaethol a system atgyfeirio electronig ar draws gofal iechyd llygaid sylfaenol ac eilaidd. I gefnogi'r digideiddio hwn, derbyniodd byrddau iechyd £3.5 miliwn o gyllid ychwanegol i gael offer newydd yn lle offer a oedd wedi dod i ddiwedd ei oes. Bydd cyflwyno'r systemau digidol newydd hyn yn helpu i fynd i'r afael â phroblemau galw mewn ysbytai, drwy rannu gofal a monitro cleifion sefydlog o fewn gofal sylfaenol, gan ddarparu gwell profiad a chanlyniadau gwell i ddinasyddion. Mae'r gronfa digideiddio a'r newid pwyslais yn ategu llwybrau cleifion, gan weithredu a darparu gwasanaethau'n ddi-dor ar draws taith y claf rhwng gofal sylfaenol a gofal eilaidd. Mae hwn yn gam sylweddol, sy'n galluogi practisau optometreg i fod y man galw cyntaf mewn gofal sylfaenol i gleifion â phroblem llygaid.