14/06/20161 Ailfodelu Swyddi Hyfforddi yng Nghymru Dulliau yn O & G Remodelling of Training Posts in Wales Approaches in O & G

The Scream 'r Gwawchia

O a G Llym Acute O&G Unedau Obstetreg – angen nifer o feddygon i ddarparu gwasanaeth 24 awr Gynaecoleg Lem – lleoliad y ddarpariaeth - Profiad ymarferol digonol ar gyfer hyfforddiant (PMETB/GMC Safon Generig 5.1) Angen Ailgyflunio gwasanaeth Cynyddu maint rota Obstetric Units - need large numbers of doctors to run 24 hour service delivery Acute Gynaecology – location of delivery - Sufficient practical experience for training (PMETB/GMC Generic Standard 5.1) Needs Reconfiguration of service Rota size to be increased

Llai o FTSTA, LAT a Graddau Bwrdd Iechyd Cynyddu ansawdd gwasanaeth a hyfforddiant – Meddygon ymgynghorol preswyl ar-alwad – goruchwylio a hyfforddi’r staff iau Reduction in FTSTA, LAT & Trust Grades Increase service and training quality - Consultants resident on call– supervision and training of the most junior trainees O a G Llym Acute O&G

O a G Dewisol Elective O&G Darparu hyfforddiant dewisol mewn clinigau i ffwrdd o ofal llym mewn blociau - caniatau hyfforddiant cyson Darparu hyfforddiant llawfeddygaeth achosion dydd i ffwrdd o ofal llym Hyfforddiant llawfeddygaeth gynaecolegol fawr yn debygol o fod ar yr un safleoedd ag O a G llym Elective training in clinics could be delivered away from acute care in blocks that allow consistent delivery of training Day case surgical training could be delivered away from acute care Major gynaecological surgical training likely to be on same sites as acute O&G

Daearyddiaeth a System Bresennol O a G Geography & Current System for O&G Geography in Wales creates some unique problems Public outcry if any current O&G unit stops delivering babies : Travel times potentially increase – compensation must be increased quality Daearyddiaeth yng Nghymru yn creu rhai problemau unigryw Gwrthwynebiad gan y cyhoedd pe byddai unrhyw uned O a G presennol yn rhoi’r gorau i enedigaethau Posibilrwydd y byddai amseroedd teithio yn cynyddu – gwneud iawn drwy wella ansawdd

Daearyddiaeth a Phryderon System Bresennol O a G Geography &Concerns of Current System for O&G Units close to the Border with England could lose deliveries to English Units in the event of any closures Glan Clwyd to Chester Wrexham to Chester and Shrewsbury Powys MLUs to Shrewsbury Gallai unedau sy’n agos at y ffin â Lloegr golli genedigaethau i Unedau yno os bydd rhai yn cau Glan Clwyd i Gaer Wrecsam i Gaer ac Amwythig Powys MLUs i Amwythig

Effaith ar Arbenigeddau Eraill Impact on Other Specialties Any changes to model of O&G training or service delivery will have an impact on the other specialties – especially Paediatrics Anaesthetics Bydd unrhyw newidiadau i fodel hyfforddiant neu ddarparu gwasanaeth O a G yn cael effaith ar yr arbenigeddau eraill – yn arbennig Paediatreg Anaestheteg

Byrddau Iechyd: Gwasanaeth dan arweiniad Meddyg Ymg. O a G Llym Health Boards: Obs & Acute Gynae Consultant Led Service BCU HB - 3 Hospitals – 7300 deliveries HD HB – 3 Hospitals – 3400 deliveries ABMU HB – 2 Hospitals – 6000 deliveries CT HB – 2 Hospitals – 4400 deliveries C&V HB – 1 Hospital – 5500 to 6000 AB HB – 2 Hospitals – 5800 to 6000 But also Midwifery Led Units in Small Hospitals BI PBC - 3 Ysbyty – 7300 genedigaeth BI HD – 3 Ysbyty – 3400 genedigaeth BI ABMU– 2 Ysbyty – 6000 genedigaeth BI CT– 2 Ysbyty – 4400 genedigaeth BI C&V– 1 Ysbyty – 5500 i 6000 BI AB – 2 Ysbyty – 5800 to 6000 Ond hefyd Unedau dan arweiniad Bydwragedd mewn Ysbytai Bach

BCHUB Options for training/service 3 Sites 2 Sites 1 Site Byrddau Iechyd Health Boards BIPBC Dewisiadau ar gyfer hyfforddiant/gwasanaeth 3 Safle 2 Safle 1 Safle

Byrddau Iechyd Health Boards BCUHB Acute Obstetrics and Gynaecology with training in Wrexham and Bangor. Out patient services and day case surgery with training in Glan Clwyd. BIPBC Obstetreg a Gynaecoleg Llym - hyfforddiant yn Wrecsam a Bangor. Gwasanaethau cleifion allanol a llawfeddygaeth achosion dydd – hyfforddiant yn Ysbyty Glan Clwyd.

Dyfodol Hyfforddiant O a G Future of O&G Training Current organisation is not sustainable Proposed organisation will have critics but will allow better quality of service and training Sefydliad presennol ddim yn gynaliadwy Bydd gan y sefydliad arfaethedig ei beirniaid ond bydd yn caniatau gwasanaeth a hyfforddiant o well ansawdd

Dyfodol Hyfforddiant O a G Future of O&G Training If proposed changes adopted, a lead-in time required to allow provision of: adequate facilities Planning of service and training delivery Os bydd y newidiadau arfaethedig yn cael eu mabwysiadu, bydd angen amser i ddarparu: cyfleusterau digonol Cynllunio ar gyfer darparu gwasanaeth a hyfforddiant

Dyfodol Hyfforddiant O a G Future of O&G Training Cyflwyniad graddol 1:cytuno cynlluniau mewn egwyddor erbyn diwedd : Os felly, cefnogi hyfforddiant a 3: Datblygu cyfleusterau 4: Cynlluniau manwl ar gael ar gyfer 5: Ad-drefnu llawn erbyn Awst 2012 Phased introduction 1:plans in principle agreed by end of :In which case training supported while 3: Facilities developed 4:Detailed plans made ready for 5: Full reorganisation by August 2012

Dyfodol Hyfforddiant O a G Future of O&G Training Os na fydd ailgyflunio gwasanaeth, yna byddai hyfforddiant O a G yng Nghymru angen newid mwy radical byth o bosib. Allwn i gefnogi hyfforddiant yn O a G yng Ngogledd Cymru? If there is no reconfiguration of service then training in O&G in Wales would probably need even more radical change Could I support training in O&G in North Wales?

Note from speaker: The content of this presentation was spoken over at the stakeholder meeting and I stated that it was a Health Board decision on how to organise service. My own personal opinion was that geography and travel times were important and that the presentation was one way that the requirement for bigger units and second on call consultants might be achieved