English: Thank you. Despite hospices putting emergency fundraising activities in place and reducing non-essential provision, there was still a very high and growing risk that hospice and end-of-life care services could slip into insolvency. That is why the Welsh Government stepped in and allocated almost £14 million of emergency funding to support Welsh hospices throughout the pandemic. This funding was provided specifically to reimburse hospices for their loss of income through their charitable activities, to protect their core services and to strengthen bereavement support. Turning specifically to our programme for government commitment to review voluntary hospice funding, the Welsh Government has made significant steps to review the specialist palliative care funding formula, implemented back in 2010-11 following the palliative care planning review undertaken by Vivienne Sugar. Following the Sugar review, an annual budget of £6.3 million was put in place to help take forward the recommendations of her report - £3 million of which was allocated to voluntary hospices. In 2014, that funding was repatriated to health board budgets and ring-fenced until 2017. While individual hospices have secured additional funding as part of service level agreements with health boards, there has been no recognised uplift of actual core costs since the original allocation back in 2010-11. Recognising this, in July 2021, I asked the end-of-life care implementation board to undertake a voluntary hospices funding review as part of a wider end-of-life care services review, which would include all statutory and voluntary sector provision. The preferred approach would have been to undertake the wider end-of-life care service review first, followed by the review of voluntary hospice funding. However, the urgent need to make recommendations for future hospice funding in time for the 2022-23 draft budget led to a prioritisation of the hospice funding review. The original funding formula centred on an evidence-based model of care, simply quantifying care delivery around numbers of beds and the largely clinical teams of consultants in palliative medicine and clinical nurse specialists. Hospice at home was excluded from the formula, and has since become a vital part of care closer to home, allowing patients to exercise their choice to die at home. The formula also did not take account of the vital role of children's hospices in supporting children with life-limiting conditions and their families through the availability of respite care. A number of significant considerations were also acknowledged at the outset of the review, including that children's hospices are inherently different from adult hospices, and a comprehensive assessment for people with palliative and end-of-life care needs had not been undertaken.
Welsh: Diolch. Er gwaethaf y ffaith i'r hosbisau roi gweithgareddau codi arian brys ar waith a lleihau'r ddarpariaeth nad oedd yn hanfodol, roedd dal risg uchel a chynyddol y gallai gwasanaethau hosbis a gofal diwedd oes yn raddol fynd yn fethdalwyr. Dyna pam y camodd Llywodraeth Cymru i mewn a dyrannu bron i £14 miliwn o gyllid brys i gefnogi hosbisau Cymru drwy gydol y pandemig. Cafodd yr arian hwn ei ddarparu yn benodol i ad-dalu hosbisau am golli incwm drwy eu gweithgareddau elusennol, i ddiogelu eu gwasanaethau craidd ac i gryfhau cymorth profedigaeth. Gan droi'n benodol at ymrwymiad ein rhaglen lywodraethu i adolygu cyllid hosbisau gwirfoddol, mae Llywodraeth Cymru wedi cymryd camau sylweddol i adolygu'r fformiwla ariannu gofal lliniarol arbenigol, a gafodd ei weithredu yn ôl yn 2010-11 yn dilyn yr adolygiad cynllunio gofal lliniarol y gwnaeth Vivienne Sugar ei gynnal. Yn dilyn adolygiad Sugar, cafodd cyllideb flynyddol o £6.3 miliwn ei rhoi ar waith i helpu i fwrw ymlaen ag argymhellion ei hadroddiad - cafodd £3 miliwn ohoni ei ddyrannu i hosbisau gwirfoddol. Yn 2014, cafodd yr arian hwnnw ei ddychwelyd i gyllidebau byrddau iechyd a'i glustnodi tan 2017. Er bod hosbisau unigol wedi sicrhau cyllid ychwanegol fel rhan o gytundebau lefel gwasanaeth gyda byrddau iechyd, nid oes unrhyw gynnydd cydnabyddedig mewn costau craidd gwirioneddol wedi bod ers y dyraniad gwreiddiol yn ôl yn 2010-11. Gan gydnabod hyn, ym mis Gorffennaf 2021, gofynnais i'r bwrdd gweithredu gofal diwedd oes gynnal adolygiad ariannu hosbisau gwirfoddol fel rhan o adolygiad ehangach o wasanaethau gofal diwedd oes, a fyddai'n cynnwys holl ddarpariaeth y sector statudol a gwirfoddol. Y dull gweithredu a fyddai wedi'i ffafrio ar y pryd fyddai cynnal yr adolygiad ehangach o'r gwasanaeth gofal diwedd oes yn gyntaf, ac yna'r adolygiad o gyllid hosbisau gwirfoddol. Fodd bynnag, arweiniodd yr angen brys i wneud argymhellion ar gyfer cyllid hosbisau yn y dyfodol mewn da bryd ar gyfer cyllideb ddrafft 2022-23 at flaenoriaethu'r adolygiad o gyllid hosbis. Roedd y fformiwla ariannu wreiddiol yn canolbwyntio ar fodel gofal sy'n seiliedig ar dystiolaeth, gan fesur y gofal sy'n cael ei ddarparu ar sail nifer y gwelyau a'r timau clinigol, yn bennaf, o ymgynghorwyr mewn meddygaeth liniarol a nyrsys clinigol arbenigol. Cafodd hosbis yn y cartref ei eithrio o'r fformiwla, ac ers hynny mae wedi dod yn rhan hanfodol o ofal yn nes at gartref, gan ganiatáu i gleifion arfer eu dewis i farw gartref. Nid oedd y fformiwla chwaith yn ystyried y rhan hanfodol yr oedd hosbisau plant yn ei chwarae yn cefnogi plant â chyflyrau sy'n cyfyngu ar eu bywydau a'u teuluoedd drwy ofalu bod gofal seibiant ar gael. Cafodd nifer o ystyriaethau arwyddocaol eu cydnabod hefyd ar ddechrau'r adolygiad, gan gynnwys bod hosbisau plant yn wahanol yn eu hanfod i hosbisau oedolion, ac nad oedd asesiad cynhwysfawr ar gyfer pobl ag anghenion gofal lliniarol a gofal diwedd oes wedi'i gynnal.