English: Thank you for the comments and questions. The Wales Audit Office, with their own programme, regularly decide what to look at in terms of public service delivery, and I have no difficulty at all with the Wales Audit Office taking a greater interest in where we are. I'm sure that, at some point, they will want to, when they decide in their judgment that it's the right time to do so. On your broader point about what we're doing about capacity, that partly goes back to the comments made with Angela Burns about having the right capacity in different parts of the system, so whether it's the local contact centre or the number of staff we have on crew, on shift, at the right time, and the different peaks and troughs in demand that are relatively predictable throughout the year as well. And I expect not just to report that, but you'll see in the quarterly ambulance quality indicators a range of information about how we're able to meet demand throughout the whole year. For example, in the amber area we publish information every quarter on the average response on the sixty-fifth percentile and the ninety-fifth percentile, so you can tell how many long waits there are within the system; you can tell where they are in different parts of the system by health board as well. What we'll also be doing immediately this winter is we will be looking to have what are referred to as welfare checks. The challenge there is whether people are calling back to check, if someone is still waiting, how they are, because often people are reporting back when deterioration has already taken place and some time ago. People often wait before they call back and say, 'This person is a lot worse', and so actually there's something about being able to more regularly call back that person and say, 'This is the position. Is there any change in the condition?' That goes back into that being the call of someone in the contact centre, or the clinician ringing them back, as to whether to change the categorisation of their call. It's not done to try and fix the system. It's done if there's extra information that the condition of that person has changed and that's the right thing to do. So, this winter we'll make sure those welfare calls are being done through the winter, when they'll be needed. On your point about whether long waits cause harm, the report also recognises that it is a challenge about patient experience; you're right to point that out. But the relationship between harm is complex and uncertain. That's why further work is needed, because the logic says that, for some conditions, if you wait a long period of time, it may well cause harm, or the condition may deteriorate. We need to understand that better to then understand whether we do need to change anything about the system to properly meet and understand people with those conditions, So, evidence has lead us to this point. The evidence we now have has led to recommendations that we'll undertake, and I'm sure that we'll have further evidence in the future on the back of the unanswered questions that the review has prompted. So, we're completely open about where we are and, as I say, I have no problem at all with the Wales Audit Office wanting to add their view as to how successful we have or haven't been on generating an improved ambulance service here in Wales.
Welsh: Diolch i chi am y sylwadau a'r cwestiynau. Mae Swyddfa Archwilio Cymru, gyda'i rhaglen eu hun, yn penderfynu'n rheolaidd beth i'w ystyried o ran darparu gwasanaethau cyhoeddus, ac nid oes gennyf unrhyw wrthwynebiad i Swyddfa Archwilio Cymru ddangos mwy o ddiddordeb yn ein sefyllfa bresennol ni. Rwy'n siŵr, ar ryw adeg, y byddan nhw eisiau gwneud hynny, pan fyddan nhw wedi penderfynu, yn ei barn nhw fod yr amser yn briodol. O ran eich pwynt ehangach ynglŷn â beth yr ydym ni'n ei wneud ynghylch capasiti, yn rhannol mae hynny'n mynd yn ôl at y sylwadau a wnaed gyda Angela Burns ynglŷn â chael y capasiti cywir mewn gwahanol rannau o'r system, pa un ai'r ganolfan gyswllt leol neu nifer y staff sydd gennym yn gweithio, ar y sifft, ar yr adeg gywir, a'r gwahanol frigau a phantiau o ran galw sy'n gymharol ragweladwy drwy gydol y flwyddyn hefyd. Ac rwy'n disgwyl adrodd am fwy na hynny, fe welwch yn y dangosyddion ansawdd chwarterol ambiwlans amrywiaeth o wybodaeth ynghylch sut yr ydym ni'n gallu ateb y galw drwy gydol y flwyddyn gyfan. Er enghraifft, yn yr adran oren rydym ni'n cyhoeddi gwybodaeth bob chwarter am ymateb cyfartalog ar y pumed ganradd a thrigain a'r bymthegfed ganradd a phedwar ugain, felly gallwch ddweud faint o amseroedd aros hir sydd o fewn y system; a gallwch ddweud lle maen nhw mewn gwahanol rannau o'r system fesul Bwrdd Iechyd hefyd. Yr hyn y byddwn yn ei wneud y gaeaf hwn ar unwaith hefyd yw ceisio cael yr hyn y cyfeirir atynt fel archwiliadau lles. Yr her yn y fan yna yw pa un a yw pobl yn galw yn ôl i wirio, os oes rhywun yn dal i aros, sut y maen nhw, oherwydd bod pobl yn aml yn adrodd yn ôl pan fo dirywiad eisoes wedi digwydd a hynny beth amser yn ôl. Mae pobl yn aml yn aros cyn galw'n ôl a dweud, 'Mae'r person hwn yn waeth o lawer', ac felly mewn gwirionedd mae rhywbeth ynghylch gallu galw'r person yn ôl a dweud, ' Dyma'r sefyllfa. A oes unrhyw newid yn y cyflwr?' Mae hynny'n mynd yn ôl at alwad gan rywun yn y ganolfan gyswllt, neu'r clinigwr yn eu ffonio nhw'n ôl, i weld a ddylid newid categori eu galwad. Nid ceisio datrys y system yw'r bwriad. Fe wneir hyn os oes gwybodaeth ychwanegol yn dangos bod cyflwr y person hwnnw wedi newid, a dyna'r peth iawn i'w wneud. Felly, fe wnawn ni wneud yn siŵr y gaeaf hwn y bydd y galwadau lles hynny yn cael eu gwneud drwy'r gaeaf, pan fydd eu hangen. Ynghylch eich pwynt o ran ba un a yw amseroedd aros hir yn achosi niwed, mae'r adroddiad hefyd yn cydnabod ei fod yn her ynghylch profiad cleifion; yr ydych yn gywir i nodi hynny. Ond mae'r berthynas rhwng niwed yn gymhleth ac ansicr. Dyna pam y mae angen mwy o waith, oherwydd dywed rhesymeg, ar gyfer rhai cyflyrau, os arhoswch chi am gyfnod hir, gallai hyn achosi niwed, neu efallai bydd y cyflwr yn gwaethygu. Mae angen inni ddeall hynny'n well, i ddeall a oes angen i ni newid unrhyw beth yn y system i gyfarfod a deall pobl â'r cyflyrau hynny'n iawn. Felly, mae tystiolaeth wedi ein harwain at y pwynt hwn. Mae'r dystiolaeth sydd gennym ni ar hyn o bryd wedi arwain at argymhellion y byddwn yn eu gweithredu, ac rwy'n sicr y cawn ni ragor o dystiolaeth yn y dyfodol yn sgil y cwestiynau sydd heb eu hateb a ysgogwyd gan yr adolygiad. Felly, rydym ni'n gwbl agored ynghylch ein sefyllfa, ac fel y dywedaf, nid oes gennyf unrhyw wrthwynebiad i Swyddfa Archwilio Cymru ychwanegu ei barn ynghylch pa mor lwyddiannus neu aflwyddiannus y buom ni o ran creu gwasanaeth ambiwlans gwell yma yng Nghymru.