Health and social care

Gwariant ar staff asiantaeth wedi “cynyddu’n sylweddol” dros y blynyddoedd diwethaf

Mae angen data cyson y gellir eu cymharu, yn ogystal ag arweinyddiaeth gref, i reoli'r gwariant ar staff dros dro, yn ôl yr Archwilydd Cyffredinol

Mae'r gwariant ar staff asiantaeth wedi cynyddu’n sylweddol dros y blynyddoedd diwethaf – cynnydd o 171% dros saith mlynedd – yn ôl adroddiad a gyhoeddir heddiw gan Archwilydd Cyffredinol Cymru. Mae tua 80% o’r gwariant ar staff asiantaeth hyd yma yn 2018-19 yn cyflenwi ar gyfer swyddi gwag ac mae’r Gwasanaeth Iechyd Gwladol (GIG) yn ceisio lleihau’r galw am staff asiantaeth a’r pris a delir amdanynt.

Yn gyffredinol, mae staff asiantaeth yn y GIG yn costio mwy na gweithwyr cyfatebol ar gontractau sylweddol. Mae'r rhai a ddarperir gan asiantaethau yn dueddol o fod yn ffynhonnell ddrutach o staff dros dro.

Mae ar GIG Cymru angen data mwy cyson y gellir eu cymharu er mwyn iddo ddeall yr hyn sydd wrth wraidd y gwariant ar staff asiantaeth. Mae angen arweinyddiaeth gref a threfniadau rheoli newid cadarn hefyd i sicrhau bod modd rhoi penderfyniadau anodd ar waith mewn ffordd gyson ledled pop corff GIG yng Nghymru.

Adroddiad ‘ffeithiau yn unig’ a gyhoeddir gan yr Archwilydd Cyffredinol heddiw. Mae’n cynnwys gwybodaeth bwysig am y modd y mae cyrff GIG Cymru’n defnyddio staff asiantaeth. Ar y cyd â’r offeryn data a grëwyd gan staff Swyddfa Archwilio Cymru, mae’n gyfle i'r darllenwyr ddod i ddeall y sefyllfa’n well a gwneud eu dadansoddiadau eu hunain o’r gwariant ar staff asiantaeth. Mae’r adroddiad hefyd yn hybu ffyrdd o wella'r sefyllfa drwy rannu gwybodaeth am fentrau cyfredol i ffrwyno’r gwariant ar staff asiantaeth, ac mae’n tynnu sylw at yr heriau perthnasol y mae’r GIG yn eu hwynebu.

Cyrhaeddodd gwariant GIG Cymru ar staff asiantaeth uchafbwynt o £164.4 miliwn yn 2016-17. Ar gyfartaledd, mae cyrff iechyd Cymru wedi gwario bron i hanner eu gwariant ar staff asiantaeth ar staff meddygol a deintyddol ers 2014-15 a thraean arall ar nyrsys a bydwragedd. Ymhlith y ffactorau sydd wedi cyfrannu at y cynnydd mewn gwariant mae’r cyfraddau fesul awr cynyddol a godir gan asiantaethau, y cynnydd yn y galw am wasanaethau, a’r anawsterau o ran recriwtio a chadw staff. Ond ni cheir dadansoddiad cenedlaethol o’r graddau y mae pob un o’r ffactorau hyn wedi cyfrannu at y cynnydd yn y gwariant ar staff asiantaeth.

Mae gan bob corff iechyd ddata am nifer y staff asiantaeth y maent yn eu defnyddio, a pham. Ond nid oes dadansoddiad ar gael o hyd ar gyfer Cymru gyfan sy’n dangos faint o feddygon, nyrsys a staff eraill sy’n cael eu cyflogi drwy asiantaethau, eu meysydd arbenigol, a’u graddau. Mae’r GIG yn gwneud trefniadau ar lefel Cymru gyfan i ddod i ddeall yn well sut y mae’n defnyddio nyrsys asiantaeth a staff asiantaeth meddygol, sef dau o’r meysydd gwariant mwyaf.

Mae’r GIG hefyd yn ceisio lleihau’r galw am staff asiantaeth drwy greu delwedd fwy deniadol o GIG Cymru fel cyflogwr, drwy geisio recriwtio a chadw mwy o staff, drwy leihau absenoldeb oherwydd salwch, a thrwy wella’r broses o reoli rotâu a chynllunio swyddi. Mae’r galw am staff asiantaeth wedi hybu cystadleuaeth rhwng cyrff iechyd a chynyddu cyfraddau tâl staff asiantaeth. Mae cyrff iechyd bellach yn cydweithio drwy weithgorau Cymru gyfan i geisio rheoli’r costau hyn.

Mae adroddiad heddiw’n pennu dwy her allweddol i wella’r broses o reoli’r gwariant ar staff asiantaeth. Yn gyntaf, mae ar GIG Cymru angen data cyson y gellir eu cymharu ar lefel Cymru gyfan i dracio nifer, natur a chost y staff asiantaeth a ddefnyddir, ac effaith newidiadau i’r gwariant ar staff asiantaeth ar gostau staffio dros dro eraill, fel taliadau goramser a banciau staff mewnol.

Yn ail, bydd angen sicrhau bod gan brosiectau i reoli’r gwariant ar staff asiantaeth a threfniadau staffio dros dro eraill arweinyddiaeth gref a chapasiti i roi newid ar waith yn ddi-oed ac i ymdrin â phenderfyniadau anodd mewn ffordd gyson.

Heddiw, dywedodd Adrian Crompton, yr Archwilydd Cyffredinol: “Mae’r adroddiad hwn yn llawn ystadegau defnyddiol sy’n darlunio’r sefyllfa o ran gwariant GIG Cymru ar staff asiantaeth ar hyn o bryd. Rwy’n gobeithio y bydd ystod eang o unigolion a gweithwyr proffesiynol yng Nghymru’n defnyddio’r adroddiad hwn, a’r offeryn data a grëwyd gennym, i helpu GIG Cymru i barhau i leihau ac i reoli’r costau hyn, a hynny ar adeg pan fo’n wynebu pwysau ariannol sylweddol.”

Diwedd

Nodiadau i olygyddion:

  • Mae’r adroddiad hwn yn amlinellu ffeithiau pwysig ynghylch y modd y mae cyrff y GIG yng Nghymru yn defnyddio staff asiantaeth, gan gynnwys y gwariant, dadansoddiadau'r cyrff iechyd o’r rhesymau dros wneud hynny, y mentrau cenedlaethol i reoli’r math hwn o wariant, a’r heriau sydd ar y gorwel.
  • Mae GIG Cymru'n cyflogi bron i 80,000 o staff cyfwerth ag amser llawn (ac eithrio Ymarferwyr Cyffredinol a’r rheini a gyflogir yn uniongyrchol gan Bractisau Cyffredinol), a gwariodd £3.62 biliwn ar gyflogau yn 2017-18.
  • Ond mae angen staff ychwanegol ar GIG Cymru hefyd i ategu’r gweithlu amser llawn pan fydd swyddi’n wag, pan fydd staff yn absennol oherwydd salwch, gwyliau neu reswm arall, neu pan fydd y galw am wasanaethau’n cynyddu, er enghraifft yn ystod pwysau'r gaeaf. Gellir llenwi’r swyddi hyn drwy wneud taliadau goramser, drwy ddefnyddio banciau staff mewnol, drwy ddefnyddio asiantaethau’r sector preifat, neu drwy ddefnyddio unigolion sy’n ymrwymo i gontractau uniongyrchol â’r cyrff iechyd ar delerau ad hoc.
  • Mae’r staff a ddarperir gan asiantaethau'n dueddol o fod yn fwy costus na staff dros dro eraill. Gyda’i gilydd, gwariodd cyrff y GIG yng Nghymru dros £160 miliwn ar staff asiantaeth yn 2016-17. Mae’r ffigur hwn dros bedair gwaith yn fwy na ffigur cyfatebol 2012-13. Mae’r gwariant ar staff asiantaeth yng ngwledydd eraill y DU wedi cynyddu’n sylweddol hefyd.
  • Archwilydd allanol statudol annibynnol y rhan fwyaf o sector cyhoeddus Cymru yw’r Archwilydd Cyffredinol Mae’n gyfrifol am gynnal archwiliad blynyddol o’r rhan fwyaf o’r arian cyhoeddus sy’n cael ei wario yng Nghymru, gan gynnwys y £15 biliwn y mae’r Cynulliad Cenedlaethol yn pleidleisio arno bob blwyddyn. Mae Llywodraeth Cymru’n trosglwyddo rhannau o’r arian hwn i GIG Cymru (dros £7 biliwn) ac i lywodraeth leol (dros £4 biliwn).
  • Mae annibyniaeth archwilio’r Archwilydd Cyffredinol yn hollbwysig. Fe’i penodir gan y Frenhines, ac nid yw’r Cynulliad Cenedlaethol na’r llywodraeth yn cyfarwyddo nac yn rheoli ei waith.
  • Corff corfforaethol a chanddo Fwrdd o naw aelod statudol yw Swyddfa Archwilio Cymru. Mae’n cyflogi staff ac yn darparu adnoddau i’r Archwilydd Cyffredinol, ac mae yntau hefyd yn gweithredu fel Prif Weithredwr a Swyddog Cyfrifyddu’r Bwrdd. Mae’r Bwrdd yn monitro ac yn cynghori’r Archwilydd Cyffredinol o ran y modd y mae’n arfer ei swyddogaethau. 

NHS spending on agency staff has “increased markedly” in recent years

Consistent and comparable data needed, along with strong leadership to manage expenditure on temporary staff, says Auditor General

NHS spending on agency staff has increased markedly in recent years – a rise of 171% over seven years - according to a report published today by the Auditor General for Wales. About 80% of agency spend to date in 2018-19 is providing cover for vacant positions and the NHS is seeking to reduce both the demand for agency staff and the price it pays for them.

Temporary staff in the NHS generally cost more than equivalent employees on substantive contracts. Those supplied by agencies tend to be the most expensive source of temporary staff.

NHS Wales now needs more consistent and comparable data to understand the root causes of agency spend. And, strong leadership and change management are also needed to achieve the consistent implementation of difficult decisions across all NHS bodies in Wales.

Today’s Auditor General report is a ‘facts only report’ which sets out the key information about the use of agency staff by NHS bodies in Wales. Together with a data-tool developed by Wales Audit Office staff, it aims to offer insight and enables readers to conduct their own analysis of agency expenditure. The report also promotes improvement by sharing information about current initiatives to curb agency spend and highlights the related challenges facing the NHS .

NHS agency spend in Wales peaked at £164.4 million in 2016-17. On average, health bodies spent nearly half of their total agency expenditure on medical and dental staff since 2014-15 and a further third on nurses and midwives. Factors that have contributed to the rise in spend includes the escalating hourly rates of pay charged by agencies; an increased demand in services and difficulties recruiting and retaining staff. But, there is no national analysis of just how much the various factors have contributed to the increase in agency spend.

Each health body holds data on how much agency staff they use and why. But, there is still no all-Wales analysis of how many doctors, nurses and other staff are being hired through agencies, their specialties and grades. The NHS is now developing arrangements at an all-Wales level to better understand nursing and medical agency usage, which are the two largest areas of spend.

The NHS is also seeking to reduce demand for agency staff through increasing the attraction of NHS Wales as an employer; trying to recruit and retain more staff; reducing sickness absence and improving rota management and job planning.  The demand for agency staff has fuelled competition between health bodies and has driven up the rates of agency pay. Health bodies are now working together via all-Wales working groups to try to control the costs.

Today’s report identifies two key challenges to improving the management of agency staffing expenditure. Firstly, NHS Wales needs consistent and comparable data at an all-Wales level to track the volume, nature and cost of agency staff used and the impact of changes in agency spend on other temporary staffing costs, such as overtime and internal staff banks.

Secondly, future projects to manage agency and other temporary staffing spend will need strong leadership and the capacity to drive change in a timely manner, to deal consistently with difficult decisions.

Auditor General, Adrian Crompton said today: “This report is packed with useful statistics and insights on the current picture of NHS agency expenditure in Wales. I hope it will be used by a wide range of people and professionals in Wales, along with the data tool we have produced, to help NHS Wales continue to bring down and control these costs at a time of significant financial pressure.”

Ends

Notes to Editors:

  • This report sets out key facts about the use of agency staff by NHS bodies in Wales – including expenditure; analyses by health bodies of underlying reasons; national initiatives to control this type of spending; and the challenges that lie ahead.
  • The NHS in Wales employs almost 80,000 full-time equivalent staff (excluding GP’s and those employed directly by GP Practices) and spent £3.62 billion on pay in 2017-18.
  • But NHS Wales also needs additional staff to supplement the full-time workforce – when key posts are vacant; staff are on sick leave, holiday or absent for some other reason; or when demand for services increases, for example through winter pressures. These posts can be filled by paid overtime; internal staff banks; private sector agencies or people who enter into a direct contract with health bodies on an ad hoc basis.
  • Staff supplied by agencies tend to be the most expensive source of temporary staff. NHS bodies in Wales collectively spent over £160 million on agency staff in 2016-17, more than four times the equivalent figure for 2012-13. There have also been large increases in agency spend in other UK countries.
  • The Auditor General is the independent statutory external auditor of the devolved Welsh public sector. He is responsible for the annual audit of the majority of the public money spent in Wales, including the £15 billion of funds that are voted on annually by the National Assembly. Elements of this funding are passed by the Welsh Government to the NHS in Wales (over £7 billion) and to local government (over £4 billion).
  • The audit independence of the Auditor General is of paramount importance. He is appointed by the Queen, and his audit work is not subject to direction or control by the National Assembly or government.
  • The Wales Audit Office (WAO) is a corporate body consisting of a nine member statutory Board which employs staff and provides other resources to the Auditor General, who is also the Board’s Chief Executive and Accounting Officer. The Board monitors and advises the Auditor General, regarding the exercise of his functions.   

Mae gwasanaethau radioleg dan straen ac mae angen gweithredu

Mae’r targedau o ran yr amseroedd aros yn cael eu bodloni ac mae’r gwasanaethau'n cael eu rheoli’n dda, ond nid yw’r sefyllfa’n gynaliadwy yn ôl yr Archwilydd Cyffredinol

Mae gwasanaethau radioleg Cymru dan bwysau oherwydd bod y galw amdanynt yn cynyddu, oherwydd anawsterau o ran recriwtio a chadw staff, oherwydd bod y cyfarpar sganio’n hen ac yn annigonol, ac oherwydd gwendidau TG. Dyma gasgliad adroddiad a gyhoeddir gan Archwilydd Cyffredinol Cymru sy’n galw am weithredu clir a phenodol i sicrhau bod modd i wasanaethau ymdopi â’r galw yn y dyfodol.

Er gwaethaf y pwysau hwn, canfu’r adroddiad fod y targedau o ran yr amseroedd aros i gael archwiliadau radioleg yn cael eu bodloni ar hyn o bryd a bod gwasanaethau radioleg yn cael eu rheoli’n dda yn gyffredinol.

Mae’r perfformiad o ran yr amseroedd aros wedi gwella yn ystod y pum mlynedd diwethaf, ac mae nifer y cleifion sy’n aros mwy nag wyth wythnos i gael archwiliad wedi gostwng. Mae’r arian ychwanegol a ddarparwyd, yn ogystal â'r camau i gyflawni archwiliadau drwy ddefnyddio unedau symudol o'r sector preifat a chapasiti sydd dros ben gan fyrddau iechyd eraill, wedi helpu i gyflawni’r gwelliannau hyn. Ond nid yw hyn yn gynaliadwy yn y tymor hir ac mae rhai cleifion yn aros am gyfnod hir i gael canlyniadau eu harchwiliadau.

Mae’r galw’n cynyddu cymaint â 15% y flwyddyn mewn rhai ardaloedd. Canfuwyd bod pob bwrdd iechyd, ac eithrio un, hefyd yn ei chael yn anodd recriwtio a chadw radiolegwyr a radiograffwyr. Mae gan bob bwrdd iechyd gyfarpar sy’n nesáu at ddiwedd ei oes ac nid yw’r system wybodaeth graidd ar gyfer radioleg yn ateb gofynion y byrddau iechyd.

Canfu’r adroddiad hefyd fod gwasanaethau’n cael eu rheoli’n dda o safbwynt gweithredol, ond bod lle i gryfhau’r gwaith craffu ar lefel y bwrdd a’r gwaith o gynllunio gwasanaethau’n strategol.

O ystyried natur rhai o’r materion y mae gwasanaethau radioleg yn eu hwynebu, ni fydd y camau a gymerir gan fyrddau iechyd ar eu pennau eu hunain yn ddigon i sicrhau bod gwasanaethau radioleg yn gynaliadwy yn y dyfodol – mae angen cynllun strategol cenedlaethol. Mae Llywodraeth Cymru wedi sefydlu Tasglu Delweddu i lunio ‘Datganiad o Fwriad o ran Delweddu’ ar lefel uchel sy’n amlinellu'r camau y mae angen i Wasanaeth Iechyd Gwladol Cymru (GIG Cymru) eu cymryd.

Mae’r adroddiad a gyhoeddir yn gwneud nifer o argymhellion sy’n canolbwyntio ar lunio a gweithredu cynllun manwl sy'n rhoi sylw digonol i'r heriau a bennwyd drwy ein gwaith ac yn y Datganiad o Fwriad o ran Delweddu.

Dywedodd Adrian Crompton, yr Archwilydd Cyffredinol:

“Mae radioleg yn rhan hollbwysig o’n Gwasanaeth Iechyd gan ei bod yn helpu i wneud diagnosis o glefydau ac anafiadau, eu monitro a’u trin. Ond mae’r gwasanaeth dan bwysau ac, er ei fod yn ymdopi ar hyn o bryd, nid yw’n debygol y bydd yn parhau i ymdopi yn y tymor hir. Mae’r adroddiad a gyhoeddir gennyf yn gwneud argymhellion clir ar lefel genedlaethol ac ar lefel leol ac rwy’n galw ar GIG Cymru i gymryd camau clir a phenodol yng ngoleuni’r adroddiad.”

Radiology services under strain and action needed

Waiting time targets being met and service well-managed but it’s unsustainable, says Auditor General

Rising demand, difficulties with recruitment and retention of staff, outdated and insufficient scanning equipment, along with IT weaknesses are putting radiology services in Wales under pressure. That’s the conclusion of a report published by the Auditor General for Wales, which calls for clear and targeted action to ensure that services are able to cope with future demand.

Despite these pressures, the report found that waiting time targets for radiology examinations are currently being met and radiology services are generally well managed.

There has been an improvement in waiting time performance over the last five years, with a reduction in the number of patients waiting more than eight weeks for an examination. This is supported by additional funding and outsourcing examinations to private sector mobile units and using spare capacity in other health boards. But, this is unsustainable in the longer term and some patients are waiting a long time for their examination results.

Demand is increasing, in some areas, by as much as 15% per year. We also found that all but one health board is struggling to recruit and retain radiologists and radiographers. All health boards have some equipment nearing the end of its life span and the core radiology information system is not fulfilling health boards’ needs.

The report also found that, while services are well managed operationally, there is scope to strengthen board level scrutiny and the strategic planning of services.

Given the nature of some of the issues facing radiology services in Wales, action taken alone by health boards will not be enough to ensure the future sustainability of radiology services – and national strategic planning is required. The Welsh Government has now established an ‘Imaging Taskforce’ to deliver a high level ‘Imaging Statement of Intent’, which contains actions for NHS Wales to address.

The report makes a number of recommendations, which focus on ensuring the development and implementation of a detailed plan which adequately addresses the challenges identified though our work and the Imaging Statement of Intent.

Auditor General, Adrian Crompton said:

“Radiology is a vitally important part of our NHS, helping to diagnose, monitor and treat disease and injuries. But it’s a service under strain and while it may be coping at the moment, this is unlikely to continue in the longer term. The report I am publishing makes some clear recommendations at national and local level and I call on NHS Wales to take clear and targeted action in response.”

Astudiaeth Gwasanaethau Cymdeithasol a Llesiant

Bydd yr astudiaeth yn adolygu'r cynnydd a wnaed gan awdurdodau lleol wrth gyflawni eu dyletswyddau newydd o dan Ddeddf Gwasanaethau Cymdeithasol a Llesiant (Cymru) 2014.

Bydd y pwynt asesu cychwynnol ar gyfer cyswllt yn cychwyn y broses o ymyrryd mewn gofal cymdeithasol ac felly bydd yn cael effaith uniongyrchol ar y math o ganlyniad y mae pobl yn ei gael. Am y tro cyntaf, mae gan ofalwyr yr un hawl i gael asesiad am gymorth ag y rhai y maent yn gofalu amdanynt.

Byddwn yn cynnal gwaith maes manwl mewn pum Cyngor: Caerdydd, Sir Ddinbych, Merthyr Tudful, Sir Benfro a Sir Gaerfyrddin.

Mae'r astudiaeth hon yn rhan o raglen flynyddol Archwilydd Cyffredinol Cymru o astudiaethau llywodraeth leol.

I gael rhagor o wybodaeth, lawrlwythwch ein taflen [PDF 140KB agorir mewn ffenest newydd].

I gofrestru diddordeb anfonwch e-bost at y astudiaethau.cyngor@archwilio.cymru

Social services and well-being study

The study will review progress by local authorities in delivering their new duties under the Social Services and Well-being (Wales) Act 2014. We will help to identify opportunities for improving current management and delivery arrangements. 

The initial point of contact assessment initiates the process of social care intervention and therefore has a direct impact on the type of outcome that people receive. For the first time, carers have an equal right to an assessment for support as those they care for.

We will carry out detailed fieldwork in five councils: Cardiff, Denbighshire, Merthyr Tydfil, Pembrokeshire and Carmarthenshire.

This study forms part of the Auditor General for Wales’ annual programme of local government studies.

For more information, please download our leaflet [PDF 140 KB opens in new window].

To register an interest please email council.studies@audit.wales

Mae gwasanaethau y tu allan i oriau o dan straen

Mae problemau staffio a lefelau morâl isel yn rhoi gwasanaethau dan straen, er bod cleifion yn ymddangos fel pe baent yn fodlon â’r gwasanaethau y maent yn eu derbyn ar y cyfan.

Mae gwasanaethau y tu allan i oriau yn darparu gofal sylfaenol brys pan fydd meddygfeydd ar gau. Maent yn rhan o gyfundrefn gofal brys ehangach sy’n cynnwys Adrannau Damweiniau ac Achosion Brys, Galw Iechyd a’r gwasanaeth 111 sydd ar ddod.

Dengys yr adroddiad fod gwasanaethau y tu allan i oriau o dan gryn straen, er gwaethaf yr adborth cadarnhaol a geir gan gleifion. Mae lefelau isel o forâl ymhlith y staff ac anawsterau wrth lenwi sifftiau yn bygwth cadernid gwasanaethau yn sawl rhan o Gymru, ac mae angen ymateb mwy cynaliadwy i’r heriau hyn.

Canfu’r adroddiad nad oedd safonau Cenedlaethol ar brydlondeb yn cael eu bodloni a bod angen gwella’r wybodaeth a ddarperir i gleifion ynghylch sut i gysylltu â gwasanaethau. Ceir diffyg gwybodaeth hefyd am ansawdd a pherfformiad gwasanaethau, ac mae hynny’n amharu ar drefniadau i’w rheoli’n effeithiol ar raddfa leol a chenedlaethol.

Fel arfer, bydd gwasanaethau y tu allan i oriau yn cael eu cynllunio ar wahân i wasanaethau eraill, er eu bod yn rhan o gyfundrefn gofal brys ehangach. Gallai’r gwasanaeth ffôn 111 newydd fod o gymorth i ddatrys rhai problemau’n gysylltiedig ag integreiddio, ond ni fydd yn datrys pob problem.

Mae llawer o’r heriau a nodir yn yr adroddiad yn bodoli ers tro, gan awgrymu bod angen ymagwedd fwy egnïol a hirdymor yn lleol a chenedlaethol er mwyn creu sylfaen gadarnach ar gyfer gwasanaethau y tu allan i oriau. Mae’n rhaid i hyn gynnwys adolygiad o’r hyn sydd angen ei fuddsoddi mewn gwasanaethau gan fod cyllid gan Lywodraeth Cymru wedi gostwng mewn termau real yn y blynyddoedd diwethaf.

Mae’r adroddiad yn cyflwyno wyth argymhelliad i helpu gwasanaethau y tu allan i oriau, sy’n cynnwys:

  • Safoni gwybodaeth i gleifion ar wefannau’r GIG a llinellau ffôn meddygfeydd;
  • Gwneud mwy i sicrhau bod gwasanaethau y tu allan i oriau yn fannau gwaith deniadol;
  • Datblygu cynllun cenedlaethol ar gyfer y gweithlu er mwyn ymdrin â phroblemau staffio; a
  • Gwneud mwy o i ledaenu ac annog arferion mwy arloesol.

Ychwanegodd Huw Vaughan-Thomas, yr Archwilydd Cyffredinol: “Mae’r adroddiad hwn yn tynnu sylw at yr angen i gryfhau gwasanaethau y tu allan i oriau ar frys. Mae angen ymdrin â heriau sy’n bodoli ers tro yn gysylltiedig â’r gweithlu ac mae angen darparu gwybodaeth well i gleifion ynghylch sut i gysylltu â gwasanaethau. Mae angen i Lywodraeth Cymru a’r byrddau iechyd gydweithio i weithredu fy argymhellion a datblygu gwelliannau cynaliadwy i’r gwasanaethau hanfodol hyn.

Out-of-hours services are under strain

Despite positive feedback from patients, staffing problems and poor morale are putting services under pressure

Out of hours services provide urgent primary care when GP surgeries are closed. They form part of the wider urgent care system that includes A&E departments, NHS Direct and the emerging 111 service.

Our report shows that out-of-hours services are under significant strain. Although patients seem generally happy with the services they get, poor staff morale and difficulties in filling shifts are threatening the resilience of services in many parts of Wales, and a more sustainable approach is needed to address these challenges.

The report found that national standards on the timeliness of appointments are not being met and that patients need to be given better information about how to access services. There is also a lack of information on service quality and performance which is hampering effective management of services at the national and local level.

The planning of out of hours services typically happens in isolation from other services despite it being part of a wider urgent care system. While the new 111 telephone service will help address some integration issues, it is not going solve all the problems.

Many of the challenges identified in the report are not new, suggesting that a more sustained and vigorous approach is needed nationally and locally to put out of hours services on a more stable footing. This must include a review of the investment that is needed given that funding from Welsh Government for these services has fallen in real terms in recent years.

The report makes eight recommendations to help improve out-of-hours services, which include:

  • Standardising patient information on NHS websites and GP phone lines;
  • Doing more to make out-of-hours services more attractive places to work;
  • Developing a national workforce plan to tackle staffing problems; and
  • Doing more to spread and encourage more innovative practices.

Auditor General Huw Vaughan-Thomas added: “This report highlights the urgent need to strengthen out of hours services and address some long standing workforce challenges. Patients also need better information on how to access services. It is essential that the Welsh Government and Health Boards work together to implement my recommendations and develop sustainable improvements to these vital services”.

Primary Care Services in Wales

The current picture

Our latest publication pulls together a range of data to provide a snapshot of primary care services in Wales.  We have collated information on:

  • The role of primary care in Wales;
  • The cost to the NHS;
  • Views from patients;
  • Issues on workforce; and
  • How the NHS is planning to develop and improve primary.

This document is different to our normal outputs as it draws together a wide range of information, highlighting the shape of current services and some of the issues and challenges they are facing.  It provides a platform for the more detailed work on primary care that our audit team will be working on locally and nationally during the remainder of 2018.

You can read the full publication online [opens in new window]

Gwasanaethau Gofal Sylfaenol yng Nghymru

Y darlun sydd ohoni

Mae’n cyhoeddiad diweddaraf yn dwyn ynghyd amrediad o ddata i ddarparu cipolwg o wasanaethau gofal sylfaenol yng Nghymru. Rydym wedi casglu gwybodaeth ar:

  • Swyddogaeth gofal sylfaenol yng Nghymru;
  • Y gost i’r GIG;
  • Safbwyntiau cleifion;
  • Materion yn ymwneud â’r gweithlu; a
  • Sut mae’r GIG yn cynllunio i ddatblygu a gwella gofal sylfaenol.

Mae’r ddogfen hon yn amrywio o’n hallbynau arferol gan ei bod yn dwyn ynghyd amrediad o wybodaeth, yn amlinellu cyflwr y gwasanaethau ar hyn o bryd a rhai o’r materion a’r heriau y maent yn eu gwynebu. Mae’n darparu platfform ar gyfer y gwaith mwy manwl ar ofal sylfaenol y bydd ein tîm archwilio yn gweithio arno yn lleol ac yn gendelaethol yn ystod gweddill 2018.

Gallwch ddarllen y cyhoeddiad llawn arlein [agorir mewn ffenest newydd]