Looking after our NHS this winter / Gofalu am ein Gwasanaeth Iechyd y gaeaf hwn

Extra surge and step-down beds in some hospitals, more medical and Out of Hours support staff and extended MIU opening hours during the peak holiday season – these are just some of the additional measures Hywel Dda is planning to put in place to counter what is expected to be an extremely difficult winter period.

With well-documented seasonal pressures now becoming year-round pressures, the health board is planning a number of operational interventions to ensure that we can continue to treat patients in the most appropriate way for their need.  This means adopting a whole-system approach which brings together acute hospitals, primary care and community settings as well as local authority and the third sector.

The plans, which will be considered at a full meeting of the health board on Thursday, 29 November 2018, include:

• Extra Out of Hours support with Advanced Paramedic Practitioners and an advice doctor joining the service
• More community staff to support extra interim care beds in Ceredigion
• Extra weekend support with more medical staff, dedicated discharge vehicles in the north and south of the Health Board, and additional therapy staff
• An extra 12 inpatient beds at Withybush General Hospital, as well as GP support at the front door during afternoons and evenings
• An ambitious and targeted flu campaign for the public and our staff
• Greater access to cardiology services to ensure patients receive quicker access to specialist tests
• Plans to develop bridging services (additional domiciliary care packages to address delayed starts of packages of care)
• Closer collaboration with care homes in Llanelli, with a view to increasing the number of beds available
• An expansion of care at home through the Acute Response Team
• Nationally facilitated initiatives to support the launch of NHS111 across the health board

In addition, the health board is also planning to add extra resilience to services during the 18 days between 21 December 2018 to 6 January 2019, when nine days within this busy period are weekends or bank holidays. 

This includes extending MIU opening hours; extra support to improve discharge – such as therapies, pharmacy, cardio-physiology and support staff; an additional Middle Grade / Consultant focused on discharge at weekends and bank holidays, and extended community pharmacy hours over weekends and bank holidays.

But we can’t do this on our own.  We need every single member of the public to play their part – and there are a number of ways you can help.

To ensure that we can treat patients who have a medical emergency, and to avoid ambulances queuing outside our A&Es or being diverted to other hospitals, we’re urging people to be Winter Wise and choose your healthcare services very carefully – for more information visit http://www.hywelddahb.wales.nhs.uk/winterwise. This will give you advice and support on choosing the right healthcare service for your need, so that we are only seeing people with urgent or emergency care needs in A&E.  Remember – every patient that turns up to A&E with a condition that could be better treated in the community, by their GP or pharmacist, or in an MIU, adds pressure on the system and means waiting times for acutely unwell patients will continue to increase.

Also, if you have a friend, family member or loved one who is medically well enough to be discharged from hospital, please help us by coming to pick them up promptly.  This will allow us to free up beds faster for acutely unwell patients and keep the patient flow steady through our hospitals. It is also important that people do not choose to remain in hospital if they are waiting to be discharged to their preferred care home; hospital is for acutely ill people and a safe and prompt discharge to the most appropriate place is essential and will achieve the best outcome for that person and their family.

Members of the public and healthcare staff are also being urged to protect themselves, their families and patients by having the flu jab. Flu can cause serious illness and can even be life threatening to people in at-risk groups so it’s essential that the public do all they can to protect themselves and others.

Joe Teape, Deputy Chief Executive and Director of Operations, said: “Last winter brought unprecedented pressures to NHS health boards and trusts across the UK and it’s fair to say that Hywel Dda experienced some really difficult periods trying to deliver urgent and emergency care services.

“Demand is so high that it’s felt like we’ve been in winter since last summer – the pressure hasn’t eased and what people don’t see is the very real knock-on effect that this has on patients with the most urgent care needs.  This could mean ambulances being delayed or diverted to other hospitals, because they can’t transfer patients immediately into busy A&E departments if there isn’t a bed available for them; it could mean that an operation you’ve been waiting for months to have being cancelled on the day you’re meant to have it because we might not have a bed for you.

“The health board has plans in place to help ease some of these pressures and hopefully enable us to see and treat patients the way we want to, but we can’t do it alone and we urgently need the public to help us.

“The NHS is here for all of us and we are extremely lucky to have it, but if we want it to look after us we’ve got to make sure we look after it too.”

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Gwelyau ymchwydd a cham-i-lawr ychwanegol mewn rhai ysbytai, mwy o staff cymorth meddygol a Thu Allan i Oriau ac oriau agor estynedig mewn Unedau Mân Anafiadau yn ystod prysurdeb y tymor – dyma rai o’r mesurai ychwanegol y mae Hywel Dda yn cynllunio eu rhoi ar waith er mwyn gwrthsefyll yr hyn a ddisgwylir i fod yn aeaf hynod o anodd. 

Gyda phwysau tymhorol bellach yn bwysau blwyddyn gron, mae’r bwrdd iechyd yn cynllunio nifer o ymyrriadau gweithrediadol er mwyn sicrhau y gallwn barhau i drin cleifion yn y ffordd fwyaf briodol i ddiwallu eu hanghenion. Golyga hyn fabwysiadu ymagwedd system-gyfan sy’n dwyn ynghyd yr ysbytai acíwt, safleoedd gofal sylfaenol a chymunedol, yn ogystal ag awdurdodau lleol a’r trydydd sector.

Mae’r cynlluniau, a fydd yn cael eu hystyried yng nghyfarfod llawn y bwrdd iechyd ddydd Iau, 29 Tachwedd 2018, yn cynnwys:

• Cymorth ychwanegol Tu Allan i Oriau gydag Uwch Ymarferwyr Parafeddygol a meddyg cynghori yn ymuno â’r gwasanaeth
• Mwy o staff cymunedol i gefnogi gwelyau gofal dros dro ychwanegol yng Ngheredigion
• Cymorth ychwanegol dros benwythnosau gyda mwy o staff meddygol, cerbydau rhyddhau penodol yng ngogledd a de ardal y bwrdd iechyd, a staff therapi ychwanegol
• 12 gwely claf mewnol ychwanegol yn Ysbyty Cyffredinol Llwynhelyg, yn ogystal â chymorth Meddyg Teulu wrth y drws blaen yn ystod prynhawniau a nosweithiau
• Ymgyrch ffliw uchelgeisiol a thargededig i’r cyhoedd a’n staff
• Mynediad ehangach at wasanaethau cardioleg er mwyn sicrhau bod cleifion yn cael mynediad cynt at brofion arbenigol
• Pontio gwasanaethau (pecynnau gofal cartref ychwanegol er mwyn mynd i’r afael â’r oedi wrth ddechrau ar becynnau gofal)
• Cydweithredu agosach gyda chartrefi gofal yn Llanelli, â’r bwriad o gynyddu nifer y gwelyau sydd ar gael
• Ymestyn gofal yn y cartref trwy’r Tîm Ymateb Acíwt
• Mentrau wedi’u hwyluso’n genedlaethol i gefnogi lansiad GIG111 ar draws y bwrdd iechyd

Yn ogystal, mae’r bwrdd iechyd yn bwriadu ychwanegu gwytnwch ychwanegol i wasanaethau yn ystod y 18 diwrnod o 21 Rhagfyr 2018 tan 6 Ionawr 2019, lle y ceir naw diwrnod sy’n benwythnos neu’n ŵyl banc mewn cyfnod prysur iawn.

Mae hyn yn cynnwys ymestyn oriau agor Unedau Mân Anafiadau; cymorth ychwanegol i wella’r broses ryddhau – megis therapïau, fferyllfa, cardio-ffisioleg a staff cefnogi; meddyg Gradd Canol / Ymgynghorol ychwanegol i ganolbwyntio ar ryddhau ar benwythnosau a gwyliau banc, ac oriau agor estynedig mewn fferyllfeydd cymunedol dros benwythnosau a gwyliau banc.

Ond ni allwn wneud hyn ar ein pen ein hunain. Mae angen i bob un aelod o’r cyhoedd chwarae ei ran – ac mae nifer o ffyrdd y medrwch helpu.

Er mwyn sicrhau y gallwn drin cleifion sydd ag argyfwng meddygol, ac i osgoi ciwiau o ambiwlansys y tu allan i’n hadrannau brys neu eu dargyfeirio i ysbytai eraill, rydym yn annog pobl i gymryd gofal y gaeaf hwn trwy fod yn ddoeth iawn ynghylch dewis gwasanaethau gofal iechyd – am fwy o wybodaeth, ewch i’n gwefan http://www.bihyweldda.wales.nhs.uk/gofalygaeaf lle y cewch gyngor a chymorth ar ddewis y gwasanaeth gofal iechyd cywir i ddiwallu eich angen, fel ein bod ni ond yn gweld pobl ag anghenion gofal brys neu argyfyngol mewn adrannau damweiniau ac achosion brys. Cofiwch – mae pob claf sy’n dod i adran frys â chyflwr a allai gael ei drin yn well yn y gymuned gan ei Feddyg Teulu neu fferyllydd, neu mewn Uned Mân Anafiadau, yn rhoi pwysau ychwangol ar y system, a golyga hyn y bydd amseroedd aros i gleifion sâl iawn yn parhau i gynyddu.

Hefyd, os oes gennych berthynas neu ffrind sy’n ddigon da yn feddygol i gael ei ryddhau o ysbyty, helpwch ni drwy ddod i’w gasglu yn brydlon. Bydd hyn yn ein galluogi i roi’r gwelyau hyn yn gynt i gleifion sâl iawn a bydd hefyd yn ein galluogi i gynnal llif y cleifion yn ein hysbytai yn gyson. It is also important that people do not choose to remain in hospital if they are waiting to be discharged to their preferred care home; hospital is for acutely ill people and a safe and prompt discharge to the most appropriate place is essential and will achieve the best outcome for that person and their family.

Mae’r cyhoedd a staff gofal iechyd hefyd yn cael eu hannog i ddiogelu eu hunain, eu teuluoedd a chleifion trwy gael y brechlyn ffliw. Gall y ffliw achosi salwch difrifol a gall beryglu bywyd y bobl hynny sydd yn un o’r grwpiau risg, felly mae’n hanfodol bod y cyhoedd yn gwneud popeth posibl i ddiogelu eu hunain ac eraill.

Meddai Joe Teape, Dirprwy Brif Weithredwr a Chyfarwyddwr Gweithrediadau: “Yn ystod gaeaf y llynedd gwelwyd pwysau digynsail ar fyrddau iechyd ac ymddiriedolaethau’r gwasanaeth iechyd ar draws y Deyrnas Unedig, ac mae’n deg dweud bod Hywel Dda wedi profi rhai cyfnodau anodd iawn wrth geisio darparu gwasanaethau gofal brys ac argyfyngol.

“Mae’r galw mor uchel, mae fel petai ni wedi bod yng nghanol gaeaf ers haf y llynedd, a dyw’r pwysau heb leihau. Ond dyw pobl ddim yn gweld yr effaith gref iawn gaiff hyn ar y cleifion sydd â’r anghenion gofal mwyaf brys. Gallai hyn olygu ambiwlansys yn cael eu gohirio neu eu dargyfeirio i ysbytai eraill, oherwydd na allant drosglwyddo cleifion yn syth i Adrannau Damweiniau ac Achosion Brys prysur os nad oes gwely ar gael iddynt; gallai olygu canslo llawdriniaeth hir-ddisgwyledig ar y diwrnod gan nad oes gwely ar gael.

“Mae cynlluniau mewn lle gan y bwrdd iechyd i helpu i leddfu rhywfaint o’r pwysau hyn a gobeithio bydd y cynlluniau yn ein galluogi i weld a thrin cleifion yn y modd y dymunwn. Ond ni allwn wneud hyn ar ein pen ein hunain – mae taer angen y cyhoedd i’n helpu.

“Mae’r gwasanaeth iechyd yma i bob yr un ohonom ac rydym yn ffodus iawn o’i gael. Mae’n rhaid i ni ofalu am y gwasanaeth os ydym am i’r gwasanaeth ofalu amdanom ni.”