 Heddiw, 6 Rhagfyr, mae Arolygiaeth Gofal Cymru wedi cyhoeddi ei adroddiad blynyddol ar gyfer 2022-2023. Mae'r adroddiad yn crynhoi ein holl weithgarwch, gan gynnwys yr arolygiad o wasanaethau'r GIG a gwasanaethau gofal iechyd annibynnol.
Mae ein canfyddiadau yn nodi'r pwysau parhaus ar wasanaethau gofal iechyd ledled Cymru, ac yn tynnu sylw at risgiau yn ymwneud â gofal brys, pryderon ynghylch staffio, llif cleifion gwael a'r gallu i gael apwyntiadau.
Rydym wedi parhau i ganolbwyntio ar ddiogelwch cleifion drwy ein gwaith arolygu a sicrwydd drwy herio gwasanaethau gofal iechyd i edrych am ffyrdd gwahanol o weithio i wella canlyniadau i gleifion. Ymgysylltodd staff gofal iechyd yn dda â'n harolygiadau a gwnaethant weithio'n adeiladol i fynd i'r afael ag unrhyw faterion a nodwyd. Mae ein hadroddiad blynyddol yn nodi sut y gwnaethom gyflawni ein swyddogaethau ledled Cymru, gan geisio sicrwydd ar ansawdd a diogelwch gofal iechyd drwy amrywiaeth o weithgareddau. Mae hyn yn cynnwys arolygiadau a gwaith adolygu yn y GIG, a gwaith sicrwydd rheoliadol yn y sector gofal iechyd annibynnol. Mae'r adroddiad yn crynhoi canfyddiadau ein gwaith, y prif heriau a wynebir ym maes gofal iechyd ledled Cymru, a'n barn am bryderon cenedlaethol a lleol.
Mae ein canfyddiadau yn dangos pwysau di-ildio ar wasanaethau gofal iechyd ledled Cymru, ac er bod mentrau ar waith i helpu gwasanaethau gofal iechyd i ymdopi â'r galw cynyddol, ni chanfu ein gwaith yn ystod y flwyddyn hon unrhyw dystiolaeth i ddangos bod y mentrau hyn yn gwneud gwahaniaeth clir a sylweddol i wasanaethau rheng flaen. Er y gallai cleifion fod wedi bod yn fodlon ar y staff a oedd yn darparu eu gofal, nid oeddent yn fodlon ar yr amseroedd aros hir na'r anhawster i gael eu trin gan wasanaethau mewn modd amserol. Er bod staff wedi parhau i ddisgrifio eu brwdfrydedd dros weithio gyda phobl a chefnogi pobl gyda'u gofal, nid oeddent yn fodlon ar y pwysau aruthrol y maent yn eu hwynebu yn eu hamgylcheddau gwaith bob dydd.
Mae ein gwaith yn ysbytai'r GIG wedi tynnu sylw at lif cleifion gwael, ynghyd â phwysau dwys dyddiol mewn perthynas â derbyn cleifion a rheoli gwelyau. Mewn Adrannau Achosion Brys ledled Cymru, rydym wedi nodi gorlenwi, cleifion yn aros am gyfnodau hir i gael eu brysbennu a'u trin, ac oedi parhaus cyn i gleifion gael eu derbyn i'r gwelyau mwyaf priodol. Ym maes Meddygaeth Gyffredinol a Deintyddiaeth, mae'r gallu i gael gafael ar wasanaethau'r GIG yn dal i beri pryder gwirioneddol i gleifion.
Er enghraifft, mae ein gwaith ym maes gwasanaethau iechyd meddwl wedi canfod oedi o ran darparu triniaeth, yn enwedig pan fydd cleifion sydd wedi cael diagnosis ac sydd â chynllun gofal a thriniaeth yn symud o un rhan o'r gwasanaeth i un arall.
Mae'r sector gofal iechyd annibynnol yn aml yn gofalu am rai o'r cleifion mwyaf agored i niwed yng Nghymru, gan ymdrin â lefelau uchel o risg ac anghenion cymhleth. Mae ein gwaith wedi ceisio herio'r sector i sicrhau bod safon ac ansawdd y gofal a ddarperir yn gyson â'i gyfrifoldebau rheoliadol er mwyn gwneud yn siŵr ei fod yn darparu gwasanaeth o safon i gleifion.
Yn ystod y flwyddyn, rydym wedi cynnal 178 o ddarnau o waith arolygu a sicrwydd ac wedi ymdrin â 659 o bryderon gan y cyhoedd a staff gofal iechyd. Maw tair thema allweddol wedi dod i'r amlwg drwy waith ein gwasanaeth monitro pryderon, sy'n ateb galwadau ac yn derbyn gwybodaeth gan aelodau o'r cyhoedd. Mae'r rhain yn ymwneud ag anawsterau i sicrhau deintydd rheolaidd a chael gofal deintyddol, anhawster i gael apwyntiad gyda meddyg teulu ac anhawster i gael gafael ar wasanaethau iechyd meddwl. Mae'r adborth hwn gan aelodau o'r cyhoedd yn peri pryder mawr ac yn rhybudd cynnar o heriau'r dyfodol ym maes iechyd cyhoedd y mae'n rhaid rhoi sylw iddynt.
Er bod yr ymatebion a gafwyd i'n holiaduron staff yn dangos lefelau isel o forâl ymysg staff, gan gynnwys heriau yn ymwneud â niferoedd staff a galw uchel am wasanaethau, nid oedd yn ymddangos bod hyn yn effeithio ar brofiadau cleifion o staff.
Drwy fynegi barn annibynnol am wasanaethau gofal iechyd, rydym yn ceisio cyfrannu at ddealltwriaeth o'r risgiau a'r heriau sy'n atal gwasanaethau rhag gweithredu'n effeithiol ac effeithio ar ansawdd y gofal a ddarperir i gleifion. Cyflwynwyd cynlluniau gwella i lawer o leoliadau yn dilyn ein canfyddiadau a'n hargymhellion, ac rydym yn parhau i fynd ar eu trywydd er mwyn sicrhau bod camau cadarn yn cael eu cymryd i wella canlyniadau.
Dywedodd Alun Jones, Prif Weithredwr Arolygiaeth Gofal Iechyd Cymru:
“Yn awr, yn fwy nag erioed ym maes gofal iechyd yng Nghymru, mae angen arloesi'n barhaus, pennu gweledigaeth a meithrin dealltwriaeth o'r hyn sy'n gweithio a'r hyn nad yw'n gweithio cystal. Yn ystod y cyfnod heriol hwn, mae gan AGIC rôl glir i'w chwarae wrth ddarparu sicrwydd annibynnol ynghylch ansawdd gwasanaethau gofal iechyd, gan dynnu sylw at arferion da a herio lle nad yw safonau'n cael eu cyrraedd.
Unwaith eto, mae ein gwaith wedi dangos y pwysau parhaus ar wasanaethau gofal iechyd ledled Cymru, ac wedi tynnu sylw at risgiau yn ymwneud â gofal brys, lefelau staffio, llif cleifion gwael a'r gallu i gael apwyntiadau. Drwy ein gwaith, rydym unwaith eto wedi gweld gweithlu hynod fedrus ac ymrwymedig, sy'n darparu gofal mewn modd tosturiol ac arloesol. Gweithlu'r GIG yw ei ased fwyaf o hyd, ac mae'n parhau i fod yn ganolog i lywio'r heriau sydd i ddod.”
 Today, 6 December, Healthcare Inspectorate Wales (HIW) has published its annual report for 2022-2023. The report summarises all of our activity, including the inspection of NHS and independent healthcare services.
Our findings outline the sustained pressure on healthcare services across Wales, highlighting risks relating to emergency care, staffing concerns, poor patient flow and the accessibility of appointments.
We have continued to focus on patient safety through our inspection and assurance work by challenging healthcare services to look for different ways of working to improve outcomes for patients. Healthcare staff engaged well with our inspections and worked constructively to tackle any issues highlighted. Our annual report sets out how we carried out our functions across Wales, seeking assurance on the quality and safety of healthcare through a range of activities. This includes inspections and review work in the NHS, and regulatory assurance work in the independent healthcare sector. The report provides a summary of what our work has found, the main challenges within healthcare across Wales, and our view on areas of national and local concern.
Our findings show unrelenting pressure on healthcare services across Wales, and whilst there are initiatives in place to help support healthcare services cope with increasing demand, our work during this year did not find evidence of these making a clear and significant difference to services at the front line. Whilst patients may well have been satisfied with the staff providing their care, they were not satisfied with the long waits and difficulty in getting treated by services in a timely manner. Whilst staff continued to describe their passion for working with people and supporting people with their care, they were not satisfied with the immensely pressured environments of work they found themselves in on a daily basis.
Our work within NHS hospitals has highlighted the issue of poor patient flow, with intense daily pressures around patient admission and bed management. Within Emergency Departments across Wales, we have noted overcrowding, long waits for triage and long waits for treatment, plus ongoing delays in being admitted into the most appropriate beds. Within General Practice and Dentistry, access to NHS services remains a matter of real concern to patients.
Our work within mental health services has found delays in treatment, in particular when patients with a diagnosis and a care and treatment plan are moving from one part of the service to another.
The independent healthcare sector often cares for some of the most vulnerable patients in Wales, dealing with high levels of risk and complex needs. Our work has sought to challenge the sector to ensure that the standards and quality provided are in line with their regulatory responsibilities so that they provide a quality service to patients.
During the year we have undertaken 178 pieces of inspection and assurance work and handled 659 concerns from the public and healthcare staff. Three key themes have arisen from our concerns monitoring service, which takes calls and information from members of the public. These are difficulties in accessing a regular dentist and receiving dental care, difficulty in getting an appointment with a GP and difficulty in accessing mental health services. This feedback from members of the public is highly concerning and is an early warning of future public health challenges which must be heeded.
Whilst the responses received to our staff questionnaires indicated low staff morale, including challenges around staffing numbers and high demand for services, this did not generally seem to impact on the experience patients had of staff.
In providing an independent view of healthcare services, we seek to contribute to an understanding of the risks and challenges that are preventing services from operating effectively and impacting on the quality of care being delivered to patients. Many settings were issued with improvement plans following our findings and recommendations, which continue to be followed up on in order to ensure robust action is taken to improve outcomes.
Alun Jones, Chief Executive of Healthcare Inspectorate Wales, said:
“Now, more than ever, healthcare in Wales needs continued innovation, and a vision and understanding of what works and what does not. In these challenging times, HIW has a clear role to play in providing independent assurance on the quality of healthcare services, highlighting what good looks like and providing challenge where standards are not being met.
Our work has once again illustrated the sustained pressure on healthcare services across Wales, highlighting risks relating to emergency care, staffing levels, poor patient flow and the accessibility of appointments. Through our work we have once again seen a highly skilled and committed workforce, delivering care with compassion and innovation. The workforce of the NHS remains its biggest asset and is central to navigating the challenges that lie ahead.”
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