English: Diolch yn fawr. Thank you to Altaf Hussain, who is my secret special adviser in the NHS, for bringing forward this short debate and for his recent invitation to Cwm Taf Morgannwg to meet with clinicians delivering those prehabilitation services. I very much look forward to our joint visit next month. I recognise how important it is to help people get ready for their cancer treatment and for them to be in the best place possible in terms of condition for a good recovery. So, being referred with suspected cancer and then waiting, often in fear, as you've suggested, with a huge degree of uncertainty until the tests and the treatment come around is a really difficult experience for many people. So, rather than wasting this time and leaving people to cope, we have an opportunity here to get them ready and to empower them to take some control. This is always something they can do, even if it's over a few weeks, to get themselves ready. Actions can include addressing the psychological impact of a diagnosis and developing some coping techniques and strategies. And as you've suggested, people can work on their nutrition and their fitness and their strength so that they are ready to face their treatment and have, as you both suggested, a better chance of recovery afterwards. So, if we can be alongside people, giving them that emotional support, encouraging and supporting people with appropriate changes to their lifestyle, then they'll have a better experience and a better chance of a good outcome. Prehabilitation enables people with cancer to prepare for cancer treatment, maximising their ability to withstand the side effects. Evidence suggests that prehabilitation delivers better outcomes with fewer complications. If the impact of prehabilitation was achieved by a drug, we'd no doubt be prescribing it, so we need to work together to put this support in place, and that's why we've set a very clear expectation in the quality statement for cancer: prehabilitation and rehabilitation are key parts of that cancer pathway. Included within the quality statement, we've introduced 21 nationally agreed cancer pathways, and these set out how the various cancer-type pathways should function and what should be involved. They all involve prehabilitation at key points in the pathway. I expect it to become a more common and standardised part of the cancer pathway over the next few years, as health boards develop new ways of working and the evidence base grows. But it's not easy, it's not just as simple as saying, 'Just do it.' The cancer clinical teams and the allied health professionals in particular are already under immense pressure, given the large increase in the number of people being referred for cancer. There's no extra money to throw at this, as we've already been providing every last bit of resource to supporting recovery in services. That's why it's important that we look at whether we can scale access to prehabilitation through digital through digital services. The Wales Cancer Network has funded pilots, and we have those pilots under way in our health boards, in collaboration with the Bevan Commission, to see if digital solutions can help. The Wales Cancer Network has also appointed a lead medical clinician and a lead cancer allied health professional to help work on this over the next two years. The post will help co-ordinate and guide the health boards' efforts, so that we can put these services in place for more cancer pathways in more health boards in a way that's sustainable. This work will be overseen by an all-Wales cancer prehabilitation group, reporting to the Wales Cancer Network board, as part of the NHS executive.
Welsh: Diolch yn fawr. Diolch i Altaf Hussain, sef fy nghynghorydd arbennig cyfrinachol yn y GIG, am gyflwyno'r ddadl fer hon ac am ei wahoddiad diweddar i Gwm Taf Morgannwg i gyfarfod â chlinigwyr sy'n darparu'r gwasanaethau rhagsefydlu hynny. Edrychaf ymlaen yn fawr at ein hymweliad ar y cyd fis nesaf. Rwy'n cydnabod pa mor bwysig yw helpu pobl i baratoi ar gyfer eu triniaeth ganser ac iddynt fod yn y lle gorau posibl o ran eu cyflwr i allu gwella'n dda. Felly, mae cael eich atgyfeirio dan amheuaeth o ganser ac yna aros, yn aml mewn ofn, fel y dywedoch chi, gyda llawer iawn o ansicrwydd nes bod y profion a'r driniaeth yn dod yn ôl yn brofiad anodd iawn i lawer o bobl. Felly, yn hytrach na gwastraffu'r amser hwn a gadael i bobl ymdopi, dyma gyfle yma i'w cael yn barod ac i'w grymuso i gymryd rhywfaint o reolaeth. Mae hyn bob amser yn rhywbeth y gallant ei wneud, hyd yn oed os yw dros ychydig wythnosau, i gael eu hunain yn barod. Gall camau gweithredu gynnwys mynd i'r afael ag effaith seicolegol diagnosis a datblygu technegau a strategaethau ymdopi. Ac fel yr awgrymoch chi, gall pobl weithio ar eu maeth a'u ffitrwydd a'u cryfder fel eu bod yn barod i wynebu eu triniaeth a gwella'r gobaith o adferiad wedyn, fel yr awgrymodd y ddau ohonoch. Felly, os gallwn ni fod wrth ochr pobl, yn rhoi cefnogaeth emosiynol iddynt, yn annog a chefnogi pobl gyda newidiadau priodol i'w ffordd o fyw, fe gânt brofiad gwell a gwell gobaith o ganlyniad da. Mae rhagsefydlu yn galluogi pobl â chanser i baratoi ar gyfer triniaeth ganser, gan wneud y gorau o'u gallu i wrthsefyll y sgil-effeithiau. Mae tystiolaeth yn awgrymu bod rhagsefydlu'n sicrhau canlyniadau gwell gyda llai o gymhlethdodau. Pe bai modd i gyffur gyflawni effaith rhagsefydlu, mae'n siŵr y byddem yn ei roi ar bresgripsiwn, felly mae angen inni weithio gyda'n gilydd i roi'r gefnogaeth hon ar waith, a dyna pam ein bod wedi gosod disgwyliad clir iawn yn y datganiad ansawdd ar gyfer canser: mae rhagsefydlu ac adsefydlu yn rhannau allweddol o'r llwybr canser. Wedi'i gynnwys yn y datganiad ansawdd, rydym wedi cyflwyno 21 llwybr canser a gytunwyd yn genedlaethol, ac mae'r rhain yn nodi sut y dylai'r gwahanol lwybrau canser weithredu a'r hyn y dylent ei gynnwys. Maent i gyd yn cynnwys rhagsefydlu ar adegau allweddol ar y llwybr. Rwy'n disgwyl iddo ddod yn rhan fwy cyffredin a safonol o'r llwybr canser dros y blynyddoedd nesaf, wrth i fyrddau iechyd ddatblygu ffyrdd newydd o weithio ac wrth i'r sylfaen dystiolaeth dyfu. Ond nid yw'n hawdd, nid yw mor syml â dweud, 'Gwnewch hyn.' Mae'r timau clinigol canser a'r gweithwyr proffesiynol perthynol i iechyd yn enwedig o dan bwysau aruthrol eisoes, o ystyried y cynnydd mawr yn nifer y bobl sy'n cael eu hatgyfeirio ar gyfer canser. Nid oes arian ychwanegol i'w daflu at hyn, gan ein bod eisoes wedi bod yn darparu pob diferyn olaf o adnodd i gefnogi adferiad gwasanaethau. Dyna pam y mae'n bwysig ein bod yn edrych i weld a allwn gynyddu mynediad at ragsefydlu drwy wasanaethau digidol. Mae Rhwydwaith Canser Cymru wedi ariannu cynlluniau peilot, ac mae gennym y cynlluniau hynny ar y gweill yn ein byrddau iechyd, mewn cydweithrediad â Chomisiwn Bevan, i weld a all atebion digidol helpu. Mae Rhwydwaith Canser Cymru hefyd wedi penodi clinigydd meddygol arweiniol ac arweinydd proffesiynol perthynol i iechyd ar gyfer canser i helpu i weithio ar hyn dros y ddwy flynedd nesaf. Bydd y swydd yn helpu i gydlynu ac arwain ymdrechion y byrddau iechyd, fel y gallwn roi'r gwasanaethau hyn ar waith ar gyfer mwy o lwybrau canser mewn rhagor o fyrddau iechyd mewn ffordd sy'n gynaliadwy. Bydd y gwaith hwn yn cael ei oruchwylio gan grŵp rhagsefydlu canser Cymru, sy'n adrodd wrth fwrdd Rhwydwaith Canser Cymru, fel rhan o weithrediaeth y GIG.