English: I really do recognise the case for wanting to raise broader public awareness, but there are times when you have to look people in the eye and say, 'I'm not sure the case is made to do that', and that is an honest reflection on the advice that I receive on the effectiveness of awareness-raising campaigns across a range of conditions. It's the reality of what, in part, my job involves: a fairly regular number of people who want the health service to conduct individual condition awareness-raising campaigns, and on a range of pretty common conditions, actually, with large numbers, like sepsis, and serious conditions as well. I always have to consider not just receiving that advice and then making choices but where is the greatest gain to be made - where is the greatest health gain to be made - and I actually think that part of our challenge is that I think that, at this point, most of the evidence points to - raising awareness amongst our health and care professionals will help to identify symptoms at an earlier stage, with more consistency, and then more consistency not just in the identification, but then in the treatment and support that people receive. I do, though, retain an open mind, and I would not say 'no' and 'never', but what I will say is that, at this point, I don't think there's a case that I could support with the advice that I have about what is the right way to deliver further improvement in outcomes to people in Wales. But I'm more than happy to keep on talking and keep on listening, and I know that there is a determined campaign to want to continue to review the evidence. And, actually, if the evidence in England is that it is not just the right thing to do from the very obvious passion that people feel around the issue, but it makes a real difference in outcomes - [ Interruption.] - then I'll be more than happy to listen and look again. The awareness amongst healthcare professionals is something that we do recognise feeds part of the inconsistency of our service responses. That's why the work that we're doing is largely aimed at health and care professionals, not just raising their awareness, but about thinking what they then do at that point in time. There's a pre-hospital sepsis group, which is a sub-group of the RRAILS programme. That's been established, and it draws together a variety of stakeholders to plan for improving practice in the outside hospital environment. A number of projects initiated from that work include collaboration with GP clusters about acute kidney injury and sepsis improvement, how to advise the out-of-hours and 111 groups on adopting NEWS and sepsis screening in a non-hospital setting, introducing sepsis and acute kidney injury tools in district nursing and intermediate care teams, and collaboration with the deanery here in Wales on clinical placements for GP trainees. The standardisation of best practice has led to a similar standardisation in training methods and the curriculum. RRAILS online in a modular e-learning tool developed by Abertawe Bro Morgannwg health board in collaboration with and funded by 1000 Lives Improvement. That is available to ensure that all NHS Wales staff, including medical and healthcare students, will be able to access the same level of training. Data on the uptake and the pass rate for that module to date has already shown 477 passes for one of each of the five modules. There is, of course, always more to do, but there are staff who are accessing it. I see on my regular visits around the hospital sector as well as outside hospitals that there is a raising of awareness amongst our staff about sepsis and an awareness of it and of its consequences. But the information gathered from this will feed into the data gathered as part of the ongoing peer review process. I am pleased that we have a very good working relationship with the UK Sepsis Trust, which is a member of the RRAILS steering group. We have a shared ambition to raise awareness and improve the response to sepsis. I was very happy to be invited by Angela Burns, as chair of the new cross-party group, to attend the meeting in March where we had the opportunity to hear first-hand some of the personal stories of those directly affected by sepsis, much like the story that you opened this debate with, and of course your own experience as well. I do know that sepsis does carry a terrible cost, not only in terms of mortality but, as you and others say, the effects that survivors have to carry with them. And it is therefore important to listen to sepsis survivors to hear that often they have to cope with physical and cognitive challenges, which again have been set out within the debate, and that can radically change their life, and to understand their experience as part of what we then need to do to respond to try and make sure that we continue to help that person to live their life to its fullest. So, I'm keen to understand those wider needs and what sort of arrangements need to be in place to help meet them. I'll be happy to come to a future meeting of the cross-party group to continue the openness and the conversation that I'm trying to set out and continue. We recognise we can't do this in isolation. It's important we continue to collaborate with all key partners to achieve our shared objectives. That's why I'm pleased that there is a collaborative project between the UK Sepsis Trust, the RRAILS programme, and the 1000 Lives education for patients programme, aimed at offering support to people who have post-sepsis syndrome. I'd like to close in recognising and expressing my own personal admiration for all of those people who have spoken out about their experiences with and of sepsis, people directly affected, people who have survived around them, carers, loved ones, and I recognise the tireless campaign of those people to try and make ensure there is further action, but, ultimately, that should lead to a further improvement, so that more lives are saved and more people who live through sepsis are supported in their recovery journey. That is a vital component of our shared fight against sepsis and to ensure that we build on our learning Wales-wide and we never take for granted the progress that we have made and concentrate on what more we could and should do.
Welsh: Rwyf o ddifrif yn cydnabod y ddadl dros fod eisiau codi ymwybyddiaeth y cyhoedd, ond ceir adegau pan fydd yn rhaid i chi edrych i fyw llygaid pobl a dweud, 'Nid wyf yn siŵr fod yr achos wedi'i wneud dros wneud hynny', a dyna adlewyrchiad gonest ar y cyngor a gaf ar effeithiolrwydd ymgyrchoedd codi ymwybyddiaeth ar draws amrywiaeth o gyflyrau. Dyna realiti'r hyn y mae fy swydd yn ei gynnwys, yn rhannol: nifer weddol reolaidd o bobl sydd am i'r gwasanaeth iechyd gynnal ymgyrchoedd codi ymwybyddiaeth o gyflyrau unigol, ac ar amrywiaeth o gyflyrau eithaf cyffredin mewn gwirionedd, gyda niferoedd mawr, fel sepsis, a chyflyrau difrifol hefyd. Rwyf bob amser yn gorfod ystyried, nid yn unig derbyn y cyngor hwnnw, a gwneud dewisiadau wedyn, ond lle mae modd sicrhau'r budd mwyaf - lle y gellir sicrhau'r budd mwyaf i iechyd - ac mewn gwirionedd, credaf mai dyna ran o'r her i ni yw fy mod yn credu, ar hyn o bryd, fod y rhan fwyaf o'r dystiolaeth yn awgrymu - bydd codi ymwybyddiaeth ymysg ein gweithwyr proffesiynol iechyd a gofal yn helpu i adnabod symptomau yn gynharach, gyda mwy o gysondeb, ac yna mwy o gysondeb, nid yn unig o ran adnabod, ond wedyn wrth roi triniaeth a chymorth i bobl. Fodd bynnag, rwy'n cadw meddwl agored, ac ni fuaswn yn dweud 'na' a 'byth', ond yr hyn rwy'n ei ddweud ar hyn o bryd yw nad wyf yn meddwl y gallwn gefnogi gyda'r cyngor rwy'n ei gael ynglŷn â'r ffordd gywir i sicrhau gwelliant pellach yn y canlyniadau i bobl yng Nghymru. Ond rwy'n fwy na pharod i ddal ati i siarad a gwrando, a gwn fod yna ymgyrch benderfynol dros fod eisiau parhau i adolygu'r dystiolaeth. Ac mewn gwirionedd, os mai'r dystiolaeth yn Lloegr yw mai dyma'r peth cywir i'w wneud nid yn unig o ran y brwdfrydedd amlwg iawn y mae pobl yn ei deimlo am y mater, ond ei fod yn gwneud gwahaniaeth go iawn i'r canlyniadau - [ Torri ar draws.] - yna, buaswn yn fwy na pharod i wrando ac edrych eto. Mae ymwybyddiaeth ymhlith gweithwyr proffesiynol gofal iechyd yn rhywbeth rydym yn cydnabod ei fod yn bwydo rhan o'r anghysondeb yn ymateb ein gwasanaeth. Dyna pam y mae'r gwaith rydym yn ei wneud wedi'i anelu i raddau helaeth at weithwyr proffesiynol iechyd a gofal, nid codi eu hymwybyddiaeth yn unig, ond o ran meddwl beth y maent yn ei wneud wedyn ar y pwynt hwnnw mewn amser. Ceir grŵp sepsis cyn mynd i'r ysbyty, sef is-grŵp y rhaglen RRAILS. Cafodd ei sefydlu, ac mae'n dwyn ynghyd amrywiaeth o randdeiliaid i gynllunio ar gyfer gwella ymarfer y tu allan i'r ysbyty. Mae nifer o'r prosiectau a gychwynnwyd gan y gwaith hwnnw yn cynnwys cydweithio gyda chlystyrau meddygon teulu mewn perthynas ag anaf acíwt i'r arennau a gwella sepsis, sut i roi cyngor i grwpiau y tu allan i oriau ac 111 ar fabwysiadu NEWS a sgrinio sepsis mewn lleoliadau y tu allan i'r ysbyty, cyflwyno offer sepsis ac anaf acíwt i'r arennau yng ngwaith nyrsys ardal a thimau gofal canolraddol, a chydweithio gyda'r ddeoniaeth yma yng Nghymru ar leoliadau gwaith clinigol ar gyfer meddygon teulu dan hyfforddiant. Mae safoni arferion gorau wedi arwain at safoni tebyg mewn dulliau hyfforddi a'r cwricwlwm. Offeryn e-ddysgu modiwlar yw RRAILS ar-lein a ddatblygwyd gan fwrdd iechyd Abertawe Bro Morgannwg mewn cydweithrediad gyda, ac wedi'i ariannu gan Gwella 1000 o Fywydau. Mae ar gael i sicrhau y bydd holl staff GIG Cymru, gan gynnwys myfyrwyr meddygol a gofal iechyd, yn gallu cael gafael ar yr un lefel o hyfforddiant. Mae'r data ar y defnydd a'r gyfradd sy'n llwyddo yn y modiwl hwnnw hyd yma eisoes wedi dangos bod 477 wedi llwyddo ar un o bob un o'r pum modiwl. Wrth gwrs, mae yna bob amser fwy i'w wneud, ond mae yna staff sy'n ei ddefnyddio. Ar fy ymweliadau rheolaidd o amgylch y sector ysbytai yn ogystal â'r tu allan i ysbytai, rwy'n gweld bod mwy o ymwybyddiaeth ymysg ein staff ynglŷn â sepsis ac ymwybyddiaeth ohono ac o'i ganlyniadau. Ond bydd y wybodaeth a gasglwyd o hyn yn cyfrannu at y data a gasglwyd yn rhan o broses barhaus yr adolygiadau gan gymheiriaid. Rwy'n falch fod gennym berthynas waith dda iawn gydag Ymddiriedolaeth Sepsis y DU, sy'n aelod o grŵp llywio RRAILS. Mae gennym uchelgais cyffredin i godi ymwybyddiaeth a gwella'r ymateb i sepsis. Roeddwn yn hapus iawn i gael fy ngwahodd gan Angela Burns, fel cadeirydd y grŵp trawsbleidiol newydd, i fynychu'r cyfarfod ym mis Mawrth, pan gawsom gyfle i glywed drosom ein hunain rai o hanesion personol pobl yr effeithiwyd arnynt yn uniongyrchol gan sepsis, yn debyg iawn i'r hanes a roesoch wrth agor y ddadl hon, ac wrth gwrs, eich profiad eich hun hefyd. Rwy'n gwybod bod cost erchyll ynghlwm wrth sepsis, nid yn unig o ran marwolaethau, ond fel y sonioch chi ac eraill, o ran yr effeithiau y mae'n rhaid i oroeswyr eu dioddef. Ac felly mae'n bwysig gwrando ar oroeswyr sepsis i glywed eu bod yn aml yn gorfod ymdopi â heriau corfforol a gwybyddol, sydd unwaith eto wedi cael sylw yn y ddadl, ac sy'n gallu newid eu bywydau mewn ffordd radical, a deall eu profiad fel rhan o'r hyn sy'n rhaid inni ei wneud wedyn er mwyn ymateb i geisio gwneud yn siŵr ein bod yn parhau i helpu'r person hwnnw i fyw eu bywydau mor llawn ag y bo modd. Felly, rwy'n awyddus i ddeall yr anghenion ehangach a pha fath o drefniadau sydd angen eu rhoi ar waith i helpu i'w diwallu. Buaswn yn hapus i ddod i gyfarfod o'r grŵp trawsbleidiol i barhau'r sgwrs agored rwy'n ceisio ei sefydlu a'i pharhau. Rydym yn cydnabod na allwn wneud hyn ar ein pen ein hunain. Mae'n bwysig ein bod yn parhau i gydweithio gyda'r holl bartneriaid allweddol i gyflawni'r amcanion a rannwn. Dyna pam rwy'n falch fod yna brosiect cydweithredol rhwng Ymddiriedolaeth Sepsis y DU, rhaglen RRAILS, a rhaglen addysg i gleifion 1000 o Fywydau, gyda'r nod o gynnig cefnogaeth i bobl sydd â syndrom ôl-sepsis. Hoffwn orffen drwy gydnabod a mynegi fy edmygedd personol o'r holl bobl sydd wedi siarad am eu profiadau o sepsis, pobl yr effeithiwyd arnynt yn uniongyrchol, pobl sydd wedi goroesi, gofalwyr, anwyliaid ac rwy'n cydnabod ymgyrch ddiflino'r bobl hyn i geisio sicrhau bod camau pellach yn cael eu rhoi ar waith, ond yn y pen draw, dylai hynny arwain at welliant pellach, fel bod mwy o fywydau'n cael eu hachub a mwy o bobl sy'n byw trwy sepsis yn cael eu cefnogi ar eu taith tuag at wellhad. Mae honno'n elfen hanfodol o'r frwydr a ymladdwn ar y cyd yn erbyn sepsis ac i sicrhau ein bod yn adeiladu ar ein dysgu drwy Gymru gyfan ac na fyddwn byth yn cymryd y cynnydd a wnaed gennym yn ganiataol, a'n bod yn canolbwyntio ar beth arall y gallem ac y dylem ei wneud.