English: Diolch yn fawr, Llywydd. Thank you for the opportunity to update Members on NHS winter pressures. Members will appreciate this winter is proving to be particularly challenging for health and care services across the United Kingdom. This is our third winter of living with COVID. While we knew respiratory viruses would become more prevalent this year, the disruption of seasonal patterns has made the likely impact of these viruses much more difficult to predict. Despite this, we are still delivering around 376,000 consultations and procedures a month in secondary care, in hospitals. In December, we reached about 400,000 contacts in GP and primary care services. So, every single day, every week, there are thousands of people receiving excellent care in the NHS in Wales, but what we do accept is that there are many others who are not receiving the care that they deserve. We have asked a lot of our staff over the last two and a half years, and we know pressures have meant staff have often not been able to consistently provide the level of care that they want. We also recognise the strength of feeling amongst our workforce, as reflected in the announcement of further planned strike action amongst ambulance unions, as well as the continuing action by the Royal College of Nursing. It's important to note the impact on capacity as a result of recent industrial action, and that has placed additional pressures on our systems due to reduced staffing and, in some cases, limited or no availability of certain services during these periods. We are dealing with an increasingly complex case mix of patients. We have more than 500 confirmed patients with COVID in our hospitals and we're seeing rapid increases in other respiratory viruses. In addition, other groups of patients are presenting with increased levels of serious illness, and, while the position has improved since Christmas, there are still over 900 people in hospital beds who are ready to leave but have had their discharge delayed for various reasons. Sickness absence rates among staff have also increased to 6.9 per cent. The result is greater prevalence of long delays for people trying to access care, and the risks of harm we know are associated with such delays. As a consequence, the experiences of people seeking urgent and emergency care across Wales have not always been to the standard that they deserve, and for that I am truly sorry. We went into the winter having seen record levels of demand on the 111 and ambulance services in October and November, with every expectation that these pressures would increase further throughout the winter. But let me give you an example of the extreme pressure that we saw on our services on 27 December: the 111 telephone service received the highest number of calls ever reported for a single day; the ambulance service received 210 immediately life-threatening calls, amongst the highest daily figures on record. We think 100 is high, and we had 210 on that particular day. As the First Minister said earlier, over 550 people were admitted to hospital in one day. That's the equivalent of around 5 per cent of the available bed capacity in Wales. There were 551 COVID patients in acute hospital beds, which is over 5 per cent of total bed capacity, and around a further 3 per cent of beds were occupied by patients in hospital with influenza. There was also the equivalent of 12 per cent of the total bed capacity in Wales taken up due to delayed discharges. Now, this level of pressure, at a time when staff illness and absence have had a significant impact, has created massive challenges for the system. Planning for winter started as early as April. We've worked hard, every fortnight meeting with local authorities to secure over 500 extra community beds for step-down care, and we're working towards more over the coming months, which will help improve flow throughout the health system. We must learn from the recent weeks and months, and we are committed to working with clinical leaders and professional bodies to support meaningful service redesign. We know one of the biggest challenges the health system faces is helping people to leave hospital as soon as it's safe for them to do so. Last month, I launched a new discharge planning guidance report, which sets clear expectations for health boards and regional partnership boards, and that is supported by a national flow programme. In April, we made a five-year commitment of £145 million through the regional integration fund to enable regional partnership boards to build on models of care developed to support rapid discharge and admission avoidance.
Welsh: Diolch yn fawr, Llywydd. Diolch i chi am y cyfle i roi'r wybodaeth ddiweddaraf i Aelodau am bwysau gaeaf y GIG. Mae Aelodau yn debyg iawn o fod yn deall yr her benodol sydd ar wasanaethau iechyd a gofal ledled y Deyrnas Unedig y gaeaf hwn. Hwn yw'r trydydd gaeaf y buom ni'n byw gyda COVID. Er ein bod ni'n gwybod y byddai firysau anadlol yn dod yn fwy cyffredin eleni, mae'r amharu a fu ar batrymau tymhorol wedi gwneud effaith debygol y firysau hyn yn llawer anos i'w rhagweld. Er hynny, rydym ni'n parhau i ddarparu tua 376,000 o ymgynghoriadau a gweithdrefnau bob mis o ran gofal eilaidd, mewn ysbytai. Ym mis Rhagfyr, fe gyrhaeddom ni tua 400,000 o gysylltiadau â gwasanaethau meddygon teulu a gofal sylfaenol. Felly, bob dydd, bob wythnos, mae yna filoedd o bobl yn cael gofal ardderchog yn y GIG yng Nghymru, ond yr hyn yr ydym ni'n ei dderbyn yw bod llawer o bobl eraill nad ydyn nhw'n cael y gofal y maen nhw'n ei haeddu. Rydym ni wedi gofyn llawer oddi wrth ein staff dros y ddwy flynedd a hanner diwethaf, ac rydym ni'n gwybod bod pwysau yn aml wedi golygu nad yw staff wedi gallu darparu'r lefel o ofal y bydden nhw wedi dymuno trwy'r amser. Rydym ni'n cydnabod maint yr angerdd ymhlith ein gweithlu ni hefyd, fel mae cyhoeddi rhagor o streiciau arfaethedig ymhlith yr undebau ambiwlans yn ei ddangos hefyd, yn ogystal â'r camau gweithredu parhaus gan y Coleg Nyrsio Brenhinol. Mae hi'n bwysig nodi'r effaith ar allu'r Gwasanaeth o ganlyniad i weithredu diwydiannol diweddar, ac mae hynny wedi rhoi pwysau ychwanegol ar ein systemau ni oherwydd llai o staffio ac, mewn rhai achosion, roedd gwasanaethau penodol yn ystod y cyfnodau hyn yn gyfyngedig neu ddim ar gael o gwbl. Rydym ni'n ymdrin â chymysgedd o achosion cynyddol gymhleth o ran y cleifion. Mae gennym ni fwy na 500 o gleifion y cadarnhawyd bod COVID arnyn nhw yn ein hysbytai ni ac rydym ni'n gweld cynnydd sydyn mewn feirysau anadlol eraill. Yn ogystal â hynny, mae grwpiau eraill o gleifion yn ymgyflwyno gyda lefelau uwch o salwch difrifol, ac, er bod y sefyllfa wedi gwella ers y Nadolig, mae dros 900 o bobl o hyd mewn gwelyau ysbyty sy'n barod i adael ond yn profi oedi cyn eu rhyddhau am wahanol resymau. Mae cyfraddau absenoldeb salwch ymhlith staff wedi cynyddu hyd at 6.9 y cant hefyd. Y canlyniad yw fwy o achosion o oedi hir i bobl sy'n ceisio cael gofal, ac mae'r risgiau o niwed rydym ni'n gwybod yn gysylltiedig ag oedi o'r fath. O ganlyniad, nid yw profiadau pobl sy'n ceisio gofal brys ac argyfwng ledled Cymru bob amser wedi bod i'r safon y maen nhw'n ei haeddu, ac am hynny mae'n wirioneddol ddrwg gennyf i. Fe aethom ni i mewn i'r gaeaf wedi gweld y cyfraddau uchaf erioed o alw ar y gwasanaethau 111 ac ambiwlans ym misoedd Hydref a mis Tachwedd, gyda phob disgwyliad y byddai'r pwysau hyn yn cynyddu eto trwy gydol y gaeaf. Ond gadewch i mi roi enghraifft i chi o'r pwysau eithafol a welsom ni ar ein gwasanaethau ar 27 o fis Rhagfyr: derbyniodd y gwasanaeth ffôn 111 y nifer uchaf o alwadau ar gofnod erioed ar gyfer un diwrnod; derbyniodd y gwasanaeth ambiwlans 210 o alwadau gyda pherygl einioes uniongyrchol, rhai o'r ffigyrau dyddiol uchaf ar gofnod. Rydym ni'n ystyried 100 yn rhif mawr, ac fe gawsom ni 210 ar y diwrnod arbennig hwnnw. Fel dywedodd y Prif Weinidog yn gynharach, cafodd dros 550 o bobl eu derbyn i'r ysbyty mewn un diwrnod. Mae hynny'n cyfateb i tua 5 y cant o nifer y gwelyau sydd ar gael yng Nghymru. Roedd 551 o gleifion COVID mewn gwelyau acíwt mewn ysbytai, sef dros 5 y cant o gyfanswm nifer y gwelyau, ac roedd tua 3 y cant o welyau eto yn cael eu meddiannu gan gleifion yn yr ysbyty a oedd â'r ffliw. Roedd cyfwerth â 12 y cant o gyfanswm y gwelyau yng Nghymru hefyd yn cael eu defnyddio oherwydd oediadau cyn rhyddhau cleifion. Nawr, mae pwysau o'r fath, mewn cyfnod o effaith sylweddol oherwydd salwch ac absenoldeb staff, wedi creu heriau enfawr i'r system. Dechreuodd y cynllunio ar gyfer y gaeaf mor gynnar â mis Ebrill. Rydym ni wedi gweithio yn galed, yn cyfarfod bob pythefnos ag awdurdodau lleol i sicrhau dros 500 o welyau cymunedol ychwanegol ar gyfer gofal cam-i-lawr, ac rydym ni'n gweithio tuag at fwy dros y misoedd nesaf, a fydd yn helpu i wella'r llif trwy'r system iechyd yn ei chyfanrwydd. Rhaid i ni ddysgu o'r wythnosau a'r misoedd diwethaf, ac rydym ni wedi ymrwymo i weithio gydag arweinwyr clinigol a chyrff proffesiynol i gefnogi ailgynllunio gwasanaethau ystyrlon. Fe wyddom ni mai un o'r heriau mwyaf y mae'r system iechyd yn ei wynebu yw helpu pobl i adael yr ysbyty cyn gynted ag y bydd hi'n ddiogel iddyn nhw wneud felly. Fis diwethaf, fe wnes i lansio adroddiad newydd ar gyfer y canllawiau cynllunio rhyddhau, sy'n pennu disgwyliadau eglur i fyrddau iechyd a byrddau partneriaeth rhanbarthol, ac fe gefnogir hynny gan raglen lif genedlaethol. Ym mis Ebrill, fe wnaethom ni ymrwymiad pum mlynedd o £145 miliwn drwy'r gronfa integreiddio rhanbarthol i alluogi byrddau partneriaeth rhanbarthol i adeiladu ar fodelau gofal a ddatblygwyd i gefnogi rhyddhau cyflym ac osgoi derbyniadau.