Ardaloedd yn Cefnogi Integreiddio Localities Supporting Integration Mary Burrows

1. Ardaloedd yn Cefnogi Integreiddio Localities Supporting Integration Mary Burrows

2. ‘Patrwm ar gyfer y dyfodol’ Cyfeiriad Strategol BIPBC Strategaethau Gofal, Iechyd a Lles2011/14 Cynllun 5 mlynedd Bwrdd Gweithredu Gofal Cychwynnol a Gwasanaethau Cymuned ‘A blueprint for the future’ BCUHB Strategic Direction HSCWB Strategies 2011/14 5 Year Plan Primary care & Community Services Implementation Board Blaenoriaeth CorfforaetholCorporate Priority

3. ‘Mae integreiddio yn ymwneud â’r prosesau o ddod â sefydliadau a gweithwyr proffesiynol at ei gilydd, gyda’r bwriad o wella canlyniadau i gleifion a defnyddwyr gwasanaeth drwy ddarparu gofal integredig’ (cyfieithiad - Curry & Ham, 2010) ‘ Integration is concerned with the processes of bringing organisations and professionals together, with the aim of improving outcomes for patients & service users through the delivery of integrated care.’ (Curry & Ham, 2010)

4. Gwella safon gofal Gwella profiad defnyddwyr Gwneud gofal yn fwy cost-effeithiol Improve the quality of care Improve user experience Increase the cost-effectiveness of care Pwrpas Gofal IntegredigPurpose of Integrated Care

5. Model tra threfnus o wasanaethau cymuned integredig fydd yn gweithredu fel pont rhwng gofal cychwynnol a’r ysbyty llym. Anghenion holistaidd y dinesydd wedi’u darparu gan y GIG, Awdurdodau Lleol ac asiantaethau partner eraill yn cydweithio. Rheolaeth argyfwng sy’n ymateb i agenda rhagweithiol, cydlynol ac ataliol, sy’n canolbwyntio yn arbennig ar grwpiau o gleifion risg mawr a’r rheiny sy’n fwyfwy bregus Highly organised model of integrated community services that will act as a bridge between primary care and the acute hospital. Holistic needs of the citizen and delivered by the NHS ,Local Authorities and other partner agencies working together. Reactive crisis management to a proactive, co-ordinated and preventative agenda, with a particular focus on high risk patient groups and those with increasing frailty Gosod y Cyfeiriad - Model GofalSetting the Direction – Model of Care

6. ‘Bydd staff o wahanol sefydliadau yn cyd-weithio â chleifion unigol, defnyddwyr gwasanaeth, gofalwyr a grwpiau cleifion a gwirfoddolwyr i adnabod eu hanghenion. Drwy rannu gwybodaeth, sgiliau, adnoddau a chyfleusterau, bydd timau sy’n gweithio ar draws yr ardal yna’n gweithredu cynlluniau i ateb yr anghenion hynny mor agos i’r cartref â phosib.’ (Gosod y Cyfeiriad, 2010) Staff from different organisations will work together with individual patients, service users, carers and patient and voluntary groups to identify their needs. By sharing knowledge, skills, resources and facilities, teams working across the locality will then implement plans to meet those needs as close to home as possible.’ (Setting the Direction, WAG, 2010) Gwaith Ardaloedd Locality Working

7. Digon mawr i sicrhau poblogaeth digon mawr fel sail rhesymol ar gyfer cynllunio gwasanaethau cymunedol Digon bychan i ddatblygu perthynas ac ennyn hyder hwyluso mapio gwasanaethau ac adnabod bylchau deall nodweddion penodol yr ardal Big enough to ensure a critical mass of population as a reasonable basis for planning community based services Small enough to develop relationships and establish trust facilitate mapping of services and identification of gaps understand the specific characteristics of the area Gweithio mewn Ardaloedd Locality Working

8. Integreiddiad Llorweddol ‘Mae’n anhebygol y byddai integreiddio sefydliadau yn unig yn darparu gwell canlyniadau, rhaid canolbwyntio’r ymdrech ar integreiddiad clinigol a gwasanaeth ’(Curry & Ham, 2010) Horizontal Integration ‘ Organisational integration alone is unlikely to deliver better outcomes and effort must focus on clinical and service integration’ (Curry & Ham, 2010) Sut gall Ardaloedd ddarparu cynllun gofal fel hyn? How can Localities help deliver this model of care?

9. Integreiddiad Unionsyth ‘Cyd-weithio clos rhwng iechyd a gofal cymdeithasol mewn system sy’n darparu gofal ataliol, rhagataliol, adweithiol ac adsefydliadol ac yn canolbwyntio ar anghenion y claf’ (Cyfieithiad: Gosod y Cyfeiriad, WAG 2010) Vertical Integration ‘Close alignment of health & social care in a system that delivers preventative, pre-emptive, reactive and rehabilitative care focused around the needs of the individual’ (Setting the Direction, WAG, 2010) Sut gall Ardaloedd ddarparu cynllun gofal fel hyn? How can Localities help deliver this model of care?

10. Gweledigaeth glir o ran gwneud gwahaniaeth positif i ddinasyddion Cychwyn o’r gwaelod i fyny Ystyried syniadau syml a rhad Daliwch i gredu! Have a clear vision on making a positive difference for citizens Start from the bottom up Consider simple & inexpensive innovations Keep the faith! Awgrymiadau….Some Tips….

11. Y Sialens The Challenge……

12. O Hyn/ From this…… Social Worker G.P. Practice Nurse Domiciliary Care District Nurse O.T. O.T. Diabetologist Family & Friends Cardiologist

13. I hyn/To this…. Integrated Team SAP Specialist Services Family and Friends