English: Hospitals across Wales reported considerably less time spent at the highest levels of escalation in December 2018 and January 2019 when compared to December 2017 and January 2018 respectively. When hospitals did experience those increased pressures, this winter they recovered and de-escalated quicker, and that is a real indication of improved resilience of front-line services. Hospitals have admitted fewer people over the age of 85 as emergencies this winter, compared with the previous two winters. The average length of stay for patients admitted as emergencies in December 2018 was at its lowest for over six years. There has been a continued reduction in the number of delayed transfers of care, and improvements have been made in waiting times; the number of people waiting over 36 weeks for elective care at the end of November 2018 was 41 per cent lower than November 2017, and now all health boards are in a better position than they were last year. I'm also pleased to update Members on a number of collaboratively delivered initiatives between the Welsh Government, local health boards, the Welsh ambulance service and third sector organisations that are already making a positive impact for people this winter. The Welsh ambulance service has collaborated with St John's on a falls assistance initiative, responding to 773 people who have fallen this winter. Over 85 per cent of those calls included patients over the age of 65. Patient feedback indicates 94 of people were satisfied with the response provided. Since mid December, local health boards have been working with the British Red Cross to support over 14,000 patients in eight emergency departments across the country. The pilot aims to improve staff well-being and patient experience. It supports patients and their families in emergency departments and transports patients home. The home transport includes helping to resettle patients by connecting them again to community services. That has been especially helpful for lonely people. The Hospital to Home pilot, delivered in collaboration with Care and Repair Cymru, is focusing on improving housing quality to support reductions in delayed transfers of care, prevent admissions and reduce readmission rates. Collaboration and integration with the third sector is a key facet of 'A Healthier Wales', and I'm encouraged to see further progress being made here. We're also trialling new integrated models of care this winter by deploying pharmacists into emergency departments. Again, early indications are positive. Dedicated pharmacists are now working as part of a multidisciplinary team, with some hospitals already reporting seeing up to 100 patients a week, to help support the safe and efficient delivery of care to patients in the emergency department. However, this winter has also been difficult for services and staff across health and social care. There have been occasions where patients have waited longer for advice, care or treatment than we or health and social care staff would like. Winter stomach bugs such as norovirus place additional strain on our NHS, and since October 2018 there have been 103 gastrointestinal outbreaks in hospitals and care homes across Wales. Members will be aware that the last flu season saw the highest number of GP consultations and flu cases in hospitals since the 2009 pandemic. We've increased testing following the roll-out of Welsh Government-funded rapid flu tests for patients in emergency departments across Wales. This winter we have seen a higher number of flu cases confirmed in hospitals compared to the same time last year. Despite a record number of attendances at major emergency departments, performance against the four-hour access target improved at seven out of 13 hospitals. However, it is clear that performance in particular at three sites is simply not good enough, and that has affected the national overall performance picture. Looking forward to the medium term, we're overseeing a number of programmes to support the sustainable delivery of unscheduled care services. The new primary care model will provide a 24/7 response, with the 111 service being a key component. As the 111 service rolls out over the next two to three years it will improve access through better signposting, clinical advice and treatment using a free-to-call number and other digital opportunities. There'll be greater regional and national working to meet the demand for critical advice and treatment at peak times, and 111 will be available nationally by 2022. The amber review implementation programme, which I've highlighted to Members in a previous statement, is well under way and expected to run until November 2019. I will update Members on progress on that programme over the summer. A quality and delivery framework for emergency departments is under development and includes the piloting of new measures developed alongside clinicians over the past year. This'll be the first phase of wider work to develop clinical outcome and experience measures a cross the unscheduled care system. Building on an in-depth review into how we discharge people with complex needs from hospitals, we will substantially increase focus on preventing unnecessary admission and reducing delays in hospital transfers of care for older people in 2019-20. I will also provide an update on this 'home first' approach in the summer. This reinforces our need to work across our whole health and social care system. And finally, we will launch a policy framework for unscheduled care to describe our policy expectations for local health boards and NHS trusts in the summer 2019. I will, of course, provide further detail upon its release.
Welsh: Mae ysbytai ledled Cymru wedi dweud eu bod wedi treulio cryn dipyn yn llai o amser yn y categorïau uwchgyfeirio uchaf ym mis Rhagfyr 2018 ac Ionawr 2019 o gymharu â mis Rhagfyr 2017 ac Ionawr 2018. Pan oedd ysbytai yn gweld y pwysau cynyddol hynny, y gaeaf hwn fe wnaethon nhw ddod drostynt ac isgyfeirio ynghynt, ac mae hynny'n arwydd gwirioneddol o wella cydnerthedd y gwasanaethau rheng flaen. Mae ysbytai wedi derbyn llai o bobl dros 85 oed mewn achosion brys y gaeaf hwn, o'i gymharu â'r ddau aeaf blaenorol. Roedd hyd cyfartalog arosiadau ar gyfer cleifion yn cael eu derbyn i'r ysbyty fel achosion brys ym mis Rhagfyr 2018 ar ei isaf ers mwy na chwe blynedd. Bu gostyngiad parhaus yn nifer yr achosion o oedi wrth drosglwyddo gofal, a bu gwelliannau mewn amseroedd aros; roedd nifer y bobl sy'n aros dros 36 wythnos ar gyfer gofal dewisol ar ddiwedd mis Tachwedd 2018 yn 41 y cant yn is nag ym mis Tachwedd 2017, a bellach mae pob bwrdd iechyd mewn sefyllfa well nag yr oedd y llynedd. Rwyf hefyd yn falch o roi'r newyddion diweddaraf i'r Aelodau am nifer o gynlluniau cyflawni ar y cyd rhwng Llywodraeth Cymru, byrddau iechyd lleol, gwasanaeth ambiwlans Cymru a'r trydydd sector sydd eisoes yn cael effaith gadarnhaol ar bobl y gaeaf hwn. Mae gwasanaeth ambiwlans Cymru wedi cydweithredu ag Ambiwlans Sant Ioan ar fenter cymorth cwympiadau, gan ymateb i 773 o bobl sydd wedi cwympo y gaeaf hwn. Roedd dros 85 y cant o'r galwadau hynny yn cynnwys cleifion dros 65 oed. Mae sylwadau gan gleifion yn dangos bod 94 o bobl yn fodlon ar yr ymateb a ddarparwyd. Ers canol mis Rhagfyr, mae byrddau iechyd lleol wedi bod yn gweithio gyda'r Groes Goch Brydeinig i gefnogi dros 14,000 o gleifion mewn wyth adran achosion brys ledled y wlad. Diben y cynllun arbrofol yw gwella lles a phrofiad cleifion. Mae'n cefnogi cleifion a'u teuluoedd mewn adrannau achosion brys ac yn cludo cleifion adref. Mae'r cludiant cartref yn cynnwys helpu i adsefydlu cleifion drwy eu cysylltu eto i wasanaethau cymunedol. Mae hynny wedi bod yn arbennig o ddefnyddiol i bobl unig. Mae'r arbrawf Adre o'r Ysbyty, sy'n cael ei gynnig ar y cyd â Gofal a Thrwsio Cymru, yn canolbwyntio ar wella ansawdd tai i gefnogi llai o oedi wrth drosglwyddo gofal, lleihau derbyniadau i'r ysbyty a lleihau cyfraddau aildderbyn. Mae cydweithio ac integreiddio gyda'r trydydd sector yn elfen allweddol o 'Cymru Iachach', ac mae'n galonogol gweld rhagor o gynnydd yn hyn o beth. Rydym ni hefyd yn treialu modelau integredig newydd o ofal y gaeaf hwn drwy ddefnyddio fferyllwyr mewn adrannau achosion brys. Unwaith eto, mae arwyddion cynnar yn gadarnhaol. Mae fferyllwyr penodedig bellach yn gweithio'n rhan o dîm amlddisgyblaethol, gyda rhai ysbytai eisoes yn dweud eu bod yn gweld hyd at 100 o gleifion yr wythnos, i helpu cefnogi'r gwaith o ddarparu gofal diogel ac effeithlon i gleifion yn yr adrannau achosion brys. Fodd bynnag, mae'r gaeaf hwn hefyd wedi bod yn anodd i wasanaethau a staff ym mhob rhan o'r maes iechyd a gofal cymdeithasol. Bu achlysuron lle bu cleifion yn aros yn hwy am gyngor, gofal neu driniaeth nag y buasem ni neu staff iechyd a gofal cymdeithasol yn ei ddymuno. Mae afiechydon stumog gaeaf fel norofeirws yn rhoi straen ychwanegol ar ein GIG, ac ers mis Hydref 2018 cafwyd 103 achos o haint gastroberfeddol mewn ysbytai a chartrefi gofal ledled Cymru. Bydd Aelodau yn ymwybodol bod y tymor ffliw diwethaf wedi gweld y nifer uchaf o ymgynghoriadau â meddygon teulu ac achosion o'r ffliw mewn ysbytai ers pandemig 2009. Rydym ni wedi cynyddu profion yn dilyn cyflwyno'r profion ffliw cyflym a ariennir gan Lywodraeth Cymru ar gyfer cleifion mewn adrannau achosion brys ledled Cymru. Y gaeaf hwn, rydym ni wedi gweld mwy o achosion o'r ffliw wedi eu cadarnhau mewn ysbytai o gymharu â'r un pryd y llynedd. Er gwaethaf y nifer uchaf erioed o bobl mewn adrannau achosion brys mawr, gwellodd perfformiad yn erbyn y targed pedair awr mewn saith o 13 o ysbytai. Fodd bynnag, mae'n glir nad yw perfformiad, yn benodol mewn tri safle yn ddigon da, ac mae hynny wedi effeithio ar y darlun cenedlaethol cyffredinol o ran perfformiad. Gan edrych ymlaen at y tymor canolig, rydym ni'n goruchwylio nifer o raglenni i gefnogi darparu gwasanaethau gofal heb ei drefnu mewn modd cynaliadwy. Bydd y model gofal sylfaenol newydd yn darparu ymateb 24/7, gyda'r gwasanaeth 111 yn elfen allweddol. Wrth gyflwyno'r gwasanaeth 111 dros y ddwy i dair blynedd nesaf, bydd yn gwella mynediad trwy well arwyddion, cyngor clinigol a thriniaeth gan ddefnyddio rhif ffôn am ddim a chyfleoedd digidol eraill. Bydd mwy o weithio rhanbarthol a chenedlaethol i ddiwallu'r galw am gyngor a thriniaeth gritigol yn ystod oriau brig, a bydd y gwasanaeth 111 ar gael yn genedlaethol erbyn 2022. Mae rhaglen weithredu'r adolygiad oren, yr wyf wedi tynnu sylw Aelodau ati mewn datganiad blaenorol, ar y gweill ers tro ac mae disgwyl iddi redeg tan fis Tachwedd 2019. Byddaf yn rhoi'r newyddion diweddaraf i Aelodau ynglŷn â'r cynnydd yn y rhaglen honno dros yr haf. Mae fframwaith ansawdd a darparu ar gyfer adrannau achosion brys yn cael ei ddatblygu ac mae'n cynnwys treialu mesurau newydd a ddatblygwyd ochr yn ochr â chlinigwyr dros y flwyddyn ddiwethaf. Dyma fydd cam cyntaf y gwaith ehangach i ddatblygu canlyniadau clinigol a mesurau profiad ledled y system gofal heb ei drefnu. Gan adeiladu ar adolygiad manwl ynglŷn â sut yr ydym ni'n rhyddhau pobl ag anghenion cymhleth o ysbytai, byddwn yn rhoi llawer mwy o bwyslais ar atal mynediadau diangen i ysbytai a lleihau oedi wrth drosglwyddo gofal ysbyty ar gyfer pobl hŷn yn 2019-20. Byddaf hefyd yn rhoi'r newyddion diweddaraf am y dull 'gartref yn gyntaf' hwn yn yr haf. Mae hyn yn atgyfnerthu ein hangen i weithio ledled ein system iechyd a gofal cymdeithasol. Ac yn olaf, byddwn ni'n lansio fframwaith polisi ar gyfer gofal heb ei drefnu i ddisgrifio ein disgwyliadau polisi ar gyfer byrddau iechyd lleol ac Ymddiriedolaethau'r GIG yn ystod yr haf 2019. Byddaf, wrth gwrs, yn rhoi rhagor o fanylion pan gaiff ei gyflwyno.