English: Although it has only been six months since the commencement of the programme, I'm encouraged to note improvement in the typical response time to patients in the amber category. The latest available data shows an improvement in the typical response time during every month between December last year and March of this year when compared with the same period in the previous winter. There has been a reduction in excessively long waits found by the review team, but there is still much work to be done to eradicate unacceptably long waits for some patients. This is the source of considerable focus through this programme. I expect to see an agreed plan for improvement by the programme board by the end of this month to address the remaining long tail of waits. Typical response times to amber calls in some health board areas are extremely positive and conducive to a good patient experience and clinical outcome. For instance, the typical response time to amber calls in March 2019 - at the height of winter pressures this winter - in Powys was just 18 minutes, and 20 minutes in north Wales. However, there does remain local variation, and whilst amber responsiveness in the Swansea Bay area has improved when compared to last year, there are continued challenges caused by ambulance patient handover delays at the Morriston site. In recognition of this challenge, I have directed the chief ambulance services commissioner to place immediate and targeted focus on achieving improvements at this site. A series of new actions have now been agreed with local clinical teams. These innovations are being delivered alongside broader whole-system actions in the area to improve community care and enable people to leave hospital when they are ready. We will, of course, monitor the situation closely. Members will recall that a central tenet of the amber review was the need to focus on certain groups of patients to improve experience. This included people who reside in care homes, who are more vulnerable to falling because they are frail or as a result of the complexity of their conditions. The Welsh Government has provided £1 million for the purchase of modern lifting equipment in almost every care home in Wales, which is proven to support patient experience and, if possible, enable people to stay within their own home. We understand there are now only four care homes in Wales that do not have the up-to-date lifting equipment. We've also provided funding for the Welsh Ambulance Services NHS Trust's falls assistant response service. The primary objective of this project is to enhance patient experience for people who have fallen, but who are uninjured or have minor injuries, ensuring they receive a timely response and to prevent the need for avoidable hospital admission. Falls assistant units have been utilised to attend a variety of calls within the amber and green categories involving people who have fallen or other welfare-related issues. Since 1 December 2018, falls assistant units have responded to almost 1,800 people, with an average response time of just 24 minutes. Since November 2018, I have made available extra funding to the Welsh ambulance service that has allowed it to recruit 16 additional clinicians to work on its clinical-support desk. Over 80 per cent of these additional healthcare professionals are nurses. They bring their experience and expertise to enhance the skill mix and capacity of the service. More senior clinicians were also recruited to undertake supervisory roles. As a result of this enhancement of the clinical support desk function, the Welsh ambulance service was able to resolve over 16,000 calls over the telephone between November 2018 and March 2019. This has meant thousands of people being treated in the community without the need to be taken to a hospital. The Welsh ambulance service is currently considering the optimum staffing levels to enable it to deal with up to 12 per cent of patients over the phone. While the review found that the clear majority of people felt that getting the best response for their condition was more important, even if it is not the quickest response, there was recognition that waiting for an ambulance can be an anxious time for patients and their families. In order to improve patient choice and reduce patient anxieties, the Welsh ambulance service has introduced a new script for call takers at times of high demand to help provide callers with an indication of how long they can expect to receive a response. Use of the new script will be monitored and reviewed, with a view to introducing it more widely. The Welsh ambulance service continues to engage with the public to build on its understanding of what matters to patients. The programme team is also working in partnership with community health councils, the Stroke Association and its local patient groups, and NHS Wales partners to develop measures that give greater context to ambulance response times to people who have a stroke. I'm expecting these to be available for winter 2019-20. Any measures developed will be designed for public reporting. The amber review reinforced that the ambulance service must ensure that planned resources are sufficient to meet expected demand. The trust has commissioned a capacity and demand review to inform future configuration of resources and staffing across Wales, and to improve service resilience during periods of high demand. The review is due to be completed by the end of September this year, and will be considered at the emergency ambulance services committee meeting in October. The Welsh ambulance service is currently undertaking a mapping exercise to show which services are available across Wales. This should help to identify where there are services that could and should be implemented to support work on admission avoidance. I expect this mapping exercise to be the catalyst for more consistency around pathways of care across Wales. It is clear that there is still more work to be done to support delivery of the recommendations of the amber review. However, early steps have been made to reduce typical response times to amber calls, to reduce excessively long waits for patients, and to improve the experience for some of the most vulnerable members of our communities. I will, of course, be happy to provide a further update to Members in the autumn.
Welsh: Er mai dim ond chwe mis sydd ers dechrau'r rhaglen, mae'n rhoi hwb i mi i nodi gwelliant yn yr amser ymateb nodweddiadol i gleifion yn y categori oren. Mae'r data diweddaraf sydd ar gael yn dangos gwelliant yn yr amser ymateb nodweddiadol yn ystod pob mis rhwng mis Rhagfyr y llynedd a mis Mawrth eleni o'i gymharu â'r un cyfnod yn y gaeaf blaenorol. Gwelwyd lleihad yn nifer yr arosiadau rhy hir a ganfuwyd gan y tîm adolygu, ond mae llawer o waith i'w wneud eto i ddileu amseroedd aros annerbyniol o hir ar gyfer rhai cleifion. Mae hwn yn destun pwyslais sylweddol drwy'r rhaglen hon. Rwy'n disgwyl gweld y bwrdd rhaglen yn cytuno ar gynllun gwella erbyn diwedd y mis hwn i roi sylw i'r arosiadau hir sy'n weddill. Mae amseroedd ymateb nodweddiadol i alwadau oren mewn rhai ardaloedd byrddau iechyd yn gadarnhaol iawn ac yn arwain at brofiad da i gleifion a chanlyniad clinigol. Er enghraifft, yr amser ymateb nodweddiadol i alwadau oren ym mis Mawrth 2019 - ar anterth pwysau'r gaeaf hwn - oedd 18 munud yn unig ym Mhowys, ac 20 munud yn y gogledd. Fodd bynnag, mae amrywiadau lleol o hyd, ac er bod amserau ymateb i alwadau oren yn ardal Bae Abertawe wedi gwella o gymharu â'r llynedd, mae heriau parhaus yn cael eu hachosi gan oedi wrth drosglwyddo cleifion mewn ambiwlansys ar safle Treforys. I gydnabod yr her hon, rwyf wedi cyfarwyddo prif gomisiynydd y gwasanaethau ambiwlans i roi pwyslais uniongyrchol a phenodol ar gyflawni gwelliannau yn y safle hwn. Mae cyfres o gamau gweithredu newydd wedi'u cytuno gyda thimau clinigol lleol. Mae'r datblygiadau arloesol hyn yn cael eu cyflawni ochr yn ochr â chamau gweithredu ehangach y system gyfan yn yr ardal i wella gofal cymunedol ac i alluogi pobl i adael yr ysbyty pan fyddan nhw'n barod. Fe fyddwn, wrth gwrs, yn monitro'r sefyllfa'n ofalus. Bydd yr Aelodau'n cofio mai un o egwyddorion canolog yr adolygiad oren oedd yr angen i ganolbwyntio ar grwpiau penodol o gleifion er mwyn gwella profiad. Roedd hyn yn cynnwys pobl sy'n byw mewn cartrefi gofal, sy'n fwy agored i gael codwm oherwydd eu bod yn eiddil neu oherwydd cymhlethdod eu cyflyrau. Mae Llywodraeth Cymru wedi darparu £1 miliwn ar gyfer prynu cyfarpar codi modern ym mron pob cartref gofal yng Nghymru, y profwyd ei fod yn cefnogi profiad cleifion ac, os yw'n bosibl, yn galluogi pobl i aros yn eu cartrefi eu hunain. Rydym yn deall mai dim ond pedwar cartref gofal yng Nghymru sydd heb yr offer codi cyfoes hwn erbyn hyn. Rydym hefyd wedi darparu cyllid ar gyfer gwasanaeth ymateb cynorthwywyr cwympiadau Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru. Prif amcan y prosiect hwn yw gwella profiad cleifion i bobl sydd wedi cwympo, ond sydd heb gael eu hanafu neu sydd â mân anafiadau, gan sicrhau eu bod yn derbyn ymateb prydlon ac i arbed yr angen i'w derbyn i'r ysbyty yn ddiangen. Mae unedau cynorthwywyr cwympiadau wedi eu defnyddio i fynychu amrywiaeth o alwadau yn y categorïau oren a gwyrdd sy'n cynnwys pobl sydd wedi cwympo neu faterion eraill sy'n ymwneud â lles. Ers 1 Rhagfyr 2018, mae unedau cynorthwywyr cwympiadau wedi ymateb i bron i 1,800 o bobl, gydag amser ymateb cyfartalog o ddim ond 24 munud. Ers mis Tachwedd 2018, rwyf wedi sicrhau bod cyllid ychwanegol ar gael i wasanaeth ambiwlans Cymru sydd wedi'i ganiatáu i recriwtio 16 o glinigwyr ychwanegol i weithio ar ei ddesg cymorth clinigol. Mae dros 80 y cant o'r gweithwyr gofal iechyd proffesiynol ychwanegol hyn yn nyrsys. Maen nhw'n dod â'u profiad a'u harbenigedd i wella cymysgedd sgiliau a chapasiti'r gwasanaeth. Recriwtiwyd mwy o uwch glinigwyr hefyd i ymgymryd â swyddogaethau goruchwylio. O ganlyniad i'r gwelliant hwn i swyddogaeth y ddesg cymorth clinigol, llwyddodd gwasanaeth ambiwlans Cymru i ddatrys dros 16,000 o alwadau dros y ffôn rhwng mis Tachwedd 2018 a mis Mawrth 2019. Mae hyn wedi golygu bod miloedd o bobl yn cael eu trin yn y gymuned heb fod angen mynd â nhw i ysbyty. Mae gwasanaeth ambiwlans Cymru ar hyn o bryd yn ystyried y lefelau staffio gorau posibl i'w alluogi i ymdrin â hyd at 12 y cant o gleifion dros y ffôn. Er i'r adolygiad ganfod bod y mwyafrif clir o bobl yn teimlo bod cael yr ymateb gorau i'w cyflwr yn bwysicach, hyd yn oed os nad dyma'r ymateb cyflymaf, cydnabuwyd y gall aros am ambiwlans fod yn amser pryderus i gleifion a'u teuluoedd. Er mwyn gwella'r dewis i gleifion a lleihau pryderon cleifion, mae gwasanaeth ambiwlans Cymru wedi cyflwyno sgript newydd ar gyfer y rhai sy'n derbyn galwadau ar adegau o alw uchel i helpu i roi syniad i alwyr pa mor hir y gallant ddisgwyl aros cyn cael ymateb. Bydd y defnydd o'r sgript newydd yn cael ei fonitro a'i adolygu gyda'r bwriad o'i gyflwyno'n ehangach. Mae gwasanaeth ambiwlans Cymru yn parhau i ymgysylltu â'r cyhoedd er mwyn ategu ei ddealltwriaeth o'r hyn sy'n bwysig i gleifion. Mae tîm y rhaglen hefyd yn gweithio mewn partneriaeth â chynghorau iechyd cymuned, y Gymdeithas Strôc a'i grwpiau cleifion lleol, a phartneriaid GIG Cymru i ddatblygu mesurau sy'n rhoi mwy o gyd-destun i amseroedd ymateb ambiwlansys i bobl sy'n cael strôc. Rwy'n disgwyl i'r rhain fod ar gael ar gyfer gaeaf 2019-20. Bydd unrhyw fesurau a ddatblygir yn cael eu cynllunio i'w hadrodd i'r cyhoedd. Atgyfnerthodd yr adolygiad oren fod yn rhaid i'r gwasanaeth ambiwlans sicrhau bod yr adnoddau sydd wedi'u cynllunio yn ddigonol i ateb y galw disgwyliedig. Mae'r ymddiriedolaeth wedi comisiynu adolygiad o gapasiti a galw i lywio'r gwaith o gyflunio adnoddau a staffio ledled Cymru yn y dyfodol, ac i wella cydnerthedd gwasanaethau yn ystod cyfnodau o alw uchel. Disgwylir i'r adolygiad gael ei gwblhau erbyn diwedd mis Medi eleni, a chaiff ei ystyried yng nghyfarfod y pwyllgor gwasanaethau ambiwlans brys ym mis Hydref. Ar hyn o bryd, mae gwasanaeth ambiwlans Cymru yn cynnal ymarfer mapio i ddangos pa wasanaethau sydd ar gael ledled Cymru. Dylai hyn helpu i nodi lle y ceir gwasanaethau y gellid ac y dylid eu gweithredu i gefnogi gwaith ar osgoi derbyn i ysbytai. Rwy'n disgwyl i'r ymarfer mapio hwn fod yn gatalydd ar gyfer mwy o gysondeb o ran llwybrau gofal ledled Cymru. Mae'n amlwg bod rhagor o waith i'w wneud o hyd i helpu i gyflawni argymhellion yr adolygiad oren. Fodd bynnag, mae camau cynnar wedi'u cymryd i leihau amserau ymateb nodweddiadol i alwadau oren, i leihau amseroedd aros rhy hir i gleifion, ac i wella'r profiad i rai o aelodau mwyaf agored i niwed ein cymunedau. Byddaf, wrth gwrs, yn hapus i roi diweddariad pellach i'r Aelodau yn yr Hydref.