 Y cwmffrins yw'r cynghwil, ydw chi'n gweithio'r gymryd. Mae'n gweithio'r cwmffrins yw'r cynghwil. Ac y gallai cymaint ar y gyfer y broses yma, mae'r gweithio'r gwerthau yn oed yn gweithio. Yn dda'r ffordd, mae'n gweithio ar 30 ysgolig gyda'r cynghwil yn ymdangosodol o'r cyfnodau. Mae'n gallu gydag 57 oes y rhan o'n cyfnod i'r cymryd, ac mae'n gweithio ar y dddangod o'r cyfrifiad. felly mae'n cael ei hunain, mae'n gwneud yr unrhyw y postau yn ymddangos. Yn ychydig, maen nhw'n gweithio'ch yma am y cyfnodd, a'r anhygwch ar gael y byddai'n gweithio'n gweithio'n gwneud yma yng nghylch ar y cyffredin. Mae'r wych chi'n mynd ar ddod, sydd ymddangos yn gwneud hyn o'r sefydlu ar y cyfnodd yma. Regw that is great, I think most significantly when you come through one of the hardest winters that in terms of the temperature and challenges, it is meant that these services have been under extraordinary pressure and I would like to take this opportunity with you in front of me to say I will thank you on behalf of the Welsh Government and for the people of Wales mae'r adeithas o'r fawr, mae'n felch ddweud y gallwn lleiaeth y dyma o'r wahanol yn glas arfermau a fawr o'r ddweud roedden nhw. Maen nhw'n ymddoch yn ddweud o'r cydymau ym Mweithgoeddol a'r dyfodol i ni. Mae'r sgwrs eisiau i chi wedi bod yn rhywbeth. Nug, eu chygoleu'r cyfrifiad o'r cyfrifiad ac mae'n gafodd yn gweithio gwymoedd am y hebau yng Nghycyddol ac mae'n gweithio'r cyfrifiadau. I've done some unusual visits this year. I've spent some time with blood donation services. I've had to fly in a staff centre and been serenaded by children, which is absolutely wonderful. I've been to Spender the Morning with the Consultant Nurse for the Homeless, and Satio has morning surgery seeing people come in off the streets and see the care and passion she gave to very, very vulnerable people in society. I've visited acute sectors, community, mental health, and everywhere I've gone, I've been so impressed with what I've seen. My one visit that I will spend a moment talking about is I went to Park Prison, which is just outside Bridgend, which has quite a lot of young male offenders there. One of the things that struck me about that visit was how the nurses have got the prisoners involved and engaged in preventing blood-borne viruses and the spread of disease in that community is quite profound. It was the prisoners who had actually come up with the post displays and had advised how best they could be treated. It was properly engaged, and what I would say is a part of the patient population that we wouldn't normally think about. One of the other things I found very interesting about that visit was they have what are called therapy dogs. Two black adults are there. What they find is that these very troubled young men, when they're first admitted, often can't talk openly about what's happened to them, but they engage with the animals in a way that actually a human cause that was very, very challenging. What struck me was that the dogs had become institutionalised because they would bark at anybody who's not wearing a uniform. It's a patient that the prison officer is wearing a uniform, so they were kind of a woman in a dress. I wonder if you're not supposed to be, so I feel it was really quite exciting. Now, this year has had some really remarkable moves forward in Wales in terms of progress that has driven up patient care and patient experience. I'm just going to touch on a few of the things that I think have been quite a highlight of achievement. Last year, we launched the oral health and hygiene bundle and removed the ineffectual use of mouth sauce in cleaning mouths. It has changed how we think about oral care for so many of our patients. We've continued the rollout of transforming care and transforming theatres. This is making a significant change to how we manage the clinical environment, freeing up front-line staff time to care and improving efficiencies within the service. When I visited one area, they were saying they were showing in the theatre department they started early finishes of lists and it's the surgeons that were getting most upset at being being changed in this way. I choose improving their performance as well as the efficiency of the staff. Now we've had some exciting developments in the use of information technology and gathering and using data. We have a concept of care metrics in our acute sector where we are gathering information to using real time to help clinical decision making that is right about the here and now. I think we need to move away from relying on auditory inspections that are a snapshot in time. Having an inspection once a year that tells you about these aspects of care, that's great. It's important information. If you're dealing with the here and now, you want to know today what's the infection rate like, what's the pressure also levels like in this area. Care metrics and the development of using information in that really creative way for the here and now I think is a massive step forward for us and improving our clinical decision making. On top of that, we've been able to develop for the first time anywhere that I know of a national nursing dashboard. Having care metrics of every area in Wales gathering we're able to pull up certain indicators to a national level which helps us look at performance and it is my aspiration and that of my colleagues that we turn this initiative that's come from the nursing world into a corporate clinical care dashboard so that health professionals are able at a board level to look at performance and that's one of the things we will continue to develop this year. We've had a renewed focus on the patient experience and the minister has just issued a framework out of service that describes how we should be engaging with the people that we care for, how we listen and respond and for me this is an important issue about co-production. It's not about us doing to others, they are part of the arrangements of care so we need to listen to what people are saying to us. We've had a very good approach I think to how we start thinking about dementia sufferers within our clinical areas and I'm delighted that June is going to be speaking later on this morning to you about the excellent work that her centre is doing. We have a very elderly population in Wales and so many people are going to be coming into every aspect of our care world that will have dementia to one degree or another. We need to really think about this, what's the environment like, how do we communicate, what kinds of things do the carers and families that come with them, what do they need. We need to start thinking in a different way and I've got to say that service is really responding. We're definitely seeing an uptake and an understanding spreading across Wales. Things like the butterfly scheme are now becoming quite a common place in a number of areas. We have looked at things around acuity tools. If you look at any aspect of care, who do we need? We need the right number of staff with the right skills, the right skill mix within teams. So for me actually making sure that we have tools that support services to identify who do we need to have actually in the care environment giving the care to the patients is very important. I and the other nurse directors in Wales are spending quite a lot of time and energy in coming up with a range of tools that will help these decisions. My last example, I think one that is very close to my heart is that we've been engaged in the UK wide program on modernising learning disability nursing. These are very vulnerable people that come through our services. Their health outcomes are often much much worse than the rest of the population. Recent research showed a stark thing. Somebody, a woman who has got a learning disability, is likely to live 20 years less than a woman in the general population, 20 years difference. That's very, very shocking statistic. So I'm delighted that we're able to support this UK work but to have specific focus attention here in Wales on this part of the workforce and the way that they care for people. I think it's important having gone through all those wonderful initiatives to remember that sometimes we don't get it right. And this last year has also seen some very high profile stories in the media and too well put on the Francis enquiry into mid staffs hardly not to have this speech without some reference to it and that Winterboard has also been in the news and that was an abuse in a private institution for people with learning disability. Shocking, awful stories. If you've read any of these you will be like me horrified to your core about what has happened to individuals going through these services. Now I know those two cases are in England but there are lots of lessons that we can learn from massive failures in care such as these. And I think it's very important that all of you ask yourselves could this happen in my area? Talk an idea to make sure it doesn't and never happens in my area. And that equally applies to us in Welsh Government. We're taking a very hard look at these reports and trying to determine what other things we can do to support service to make sure that we have the right systems and tools in place to make sure that we have excellent care for everyone that goes through our service. In Wales I'm afraid to say that we've had almost one case of serious incident reports and inspections that indicate that we too have had some failures. So it's really important that we're not complacent and think all those big reports that are in England issue doesn't apply to us, that's not the case. We get it one year too. So while we've got some really, really good markers of improvement, infections have required infections to still falling, pressure ulcers are falling. Very, very long rates now. In some areas like ventilator-acquired infections are practically non-existent. Fantastic, it's really good. We're still getting back for everybody in every instance and it's done to all of us to make sure that we focus on that. Now today is a day of celebration so I don't wish to spend a lot of time talking about when things go wrong. The way to make things right is to think about good practice, sharing ideas, being motivated and committed. And I know all of you are. You're here today, you're wanting to learn, you're wanting to share and that really inspires me. It really does. Now for those of you that were here last year you may recall I threw out a challenge. I hope some of you actually acted on that challenge and what I say, pick one thing that you're here today. Go away and do something about it, whether it's to look something up, try something new in your area, think content, want to speak, do something. So I'm going to restate that challenge to you again this year so you might like to think about taking two things away and doing something with it. But I hope all of you will take the opportunity to say do you know what I'm going to go back with a renewed enthusiasm to look at what we do in our area and perhaps try to focus on something that will improve care.