Manifesto briefings
Click below to access the Welsh language briefings:
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Adran 25B o Ddeddf Lefelau Staffio Nyrsio (Cymru) 2016
- Bu RCN Cymru yn ymgyrchu dros Ddeddf Lefelau Staffio Nyrsio (Cymru) 2016 (“y Ddeddf”) i amddiffyn gofal cleifion ac mae’n parhau i’w hyrwyddo. Y Ddeddf oedd y gyntaf o’i math yn Ewrop ac roedd yn diogelu lefelau staffio nyrsio mewn deddfwriaeth.
- Mae adran 25A o’r Ddeddf yn gosod dyletswydd gyffredinol ar fyrddau iechyd i roi ystyriaeth i bwysigrwydd sicrhau bod nyrsys yn cael yr amser i ofalu am eu cleifion mewn ffordd sensitif. Mae adran 25B yn gosod dyletswydd fwy penodol ar fyrddau iechyd, mewn rhai meysydd clinigol, i gyfrifo lefelau staffio nyrsio a’r cymysgedd o sgiliau, ac i gymryd pob cam rhesymol i’w cynnal, gan ddefnyddio dull penodol.
- Mae lefel y staff nyrsio yn cyfeirio at nifer y nyrsys mewn tîm a’r modd y cânt eu lleoli mewn tîm wedi’i phennu trwy ddull trionglog, barn broffesiynol, offeryn cynllunio’r gweithlu a dangosyddion sy’n sensitif i’r gofal a roddir gan nyrsys. Hefyd, mae’n ofynnol i ymddiriedolaethau a byrddau iechyd hysbysu’r cyhoedd am lefelau staff nyrsio ar bob shifft ar gyfer pob ward a gwmpesir gan Adran 25B.
I ddechrau, yn 2018, dim ond i wardiau meddygol a llawfeddygol acíwt i oedolion yr oedd Adran 25B yn berthnasol. Ar 1 Hydref 2021, cafodd ei hymestyn i gwmpasu wardiau plant.
Beth mae’r gyfraith yn ei ddweud?
Adran 25B: Duty to calculate and take steps to maintain nurse staffing levels
(1) Where a Local Health Board or NHS Trust in Wales provides nursing services in a situation to which this section applies, it must—
(a) designate a person or a description of person to calculate the number of [registered] nurses appropriate to provide care to patients that meets all reasonable requirements in that situation (the “nurse staffing level”),
(b) take all reasonable steps to maintain the nurse staffing level, and
(c) make arrangements for the purpose of informing patients of the nurse staffing level. Deddf Lefelau Staff Nyrsio (Cymru) 2016
- Yn 2024, daeth Pwyllgor Iechyd a Gofal Cymdeithasol y Senedd i’r casgliad, os na allai Llywodraeth Cymru ddangos ei bod yn cyflawni gofal diogel ac effeithiol heb ymestyn Adran 25B o Ddeddf Lefelau Staff Nyrsio (Cymru) 2016, y dylai ystyried gwneud hynny.
Mae RCN Cymru yn galw ar Lywodraeth nesaf Cymru i:
- Ymestyn Adran 25B o Ddeddf Lefelau Staff Nyrsio (Cymru) 2016 i leoliadau nyrsio cymunedol a chleifion mewnol iechyd meddwl.
- Gwneud hyn yn ymrwymiad cam cyntaf i gymhwyso Adran 25B at bob lleoliad lle darperir gofal nyrsio.
Cliciwch yma i ddarllen mwy am safbwyntiau RCN Cymru ynglŷn â Deddf Lefelau Staff Nyrsio (Cymru) 2016.
Section 25B of the Nurse Staffing Levels (Wales) Act 2016
- RCN Wales campaigned for the Nurse Staffing Levels (Wales) Act 2016 ("the Act") to protect patient care and continues to champion it. The Act was the first of its kind in Europe and protected nurse staffing levels in legislation.
- Section 25A of the Act places a general duty on health boards to "have regard to the importance of" nurses having the time to care for their patients sensitively. Section 25B places a more specific duty on health boards, in some clinical areas, to calculate and take all reasonable steps to maintain nurse staffing levels, and skill mix, using a specified method.
- The nurse staffing level is both the number and deployment of nurses in a team arrived at by triangulating, professional judgement, a workforce planning tool and nurse sensitive indicators. Health boards and trusts are also required to inform the public of the levels of nursing staff on each shift for all wards covered by Section 25B.
Initially in 2018 Section 25B only applied to acute adult medical and surgical wards. On 1 October 2021, it was extended to children's wards.
What does the law say?
Section 25B: Duty to calculate and take steps to maintain nurse staffing levels
(1) Where a Local Health Board or NHS Trust in Wales provides nursing services in a situation to which this section applies, it must—
(a) designate a person or a description of person to calculate the number of [registered] nurses appropriate to provide care to patients that meets all reasonable requirements in that situation (the "nurse staffing level"),
(b) take all reasonable steps to maintain the nurse staffing level, and
(c) make arrangements for the purpose of informing patients of the nurse staffing level. Nurse Staffing Levels (Wales) Act 2016
- In 2024, the Senedd Health and Social Care Committee concluded that if the Welsh Government could not show it was achieving safe and effective care without extending Section 25B of the Nurse Staffing Levels (Wales) Act 2016, it should consider doing so.
RCN Wales calls on the next Welsh Government to:
- Extend Section 25B of Nurse Staffing Levels (Wales) Act 2016 to community nursing and mental health inpatient settings.
- Make this a first step commitment to applying Section 25B in all settings where nursing care is provided.
Read more about RCN Wales positions regarding the Nurse Staffing Levels (Wales) Act 2016.
Y ddyletswydd ansawdd
- Mae Rhan 2 o Ddeddf Iechyd a Gofal Cymdeithasol (Ansawdd ac Ymgysylltu) (Cymru) 2020 yn ei gwneud yn ofynnol i Lywodraeth Cymru lunio adroddiad blynyddol sy’n nodi sut mae’n “sicrhau gwelliant yn ansawdd [y] gwasanaethau iechyd”, a gosod yr adroddiad hwnnw gerbron y Senedd.
- Hefyd, rhaid i gyrff iechyd yng Nghymru gyhoeddi “asesiad” tebyg bob blwyddyn. Mae’n ofynnol i Lywodraeth Cymru ddarparu canllawiau ar y dystiolaeth i’w defnyddio yn yr asesiad hwn ac wrth fynd ati i gynnal asesiad o’r fath.
Sut mae ‘ansawdd’ yn cael ei ddiffinio
- Mae’r ddeddfwriaeth yn diffinio ‘ansawdd’ i gynnwys DIOGELWCH gwasanaethau, EFFEITHIOLRWYDD gwasanaethau a PHROFIAD defnyddwyr gwasanaethau.
- Wrth i’r Bil gael ei ddatblygu yn 2019, bu RCN Cymru yn eirioli dros ddiffiniad ehangach o ‘ansawdd’ i’w fabwysiadu yn y Bil, a fyddai hefyd wedi cynnwys trafodaeth am faterion yn ymwneud â’r GWEITHLU. Fodd bynnag, ni chafodd hyn ei adlewyrchu yn nrafft terfynol y Bil.
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Problem arall yw nad yw’r Ddeddf yn ei gwneud yn ofynnol i fyrddau iechyd adrodd ar achosion o ofal sy’n cael ei ddarparu mewn ardal amhriodol fel ar gadair am fwy na 24 awr.
- Nid yw cadeiriau wedi’u cynllunio i’w defnyddio’n barhaus gan glaf dros gyfnod estynedig. Mae’r profiad yn anghyfforddus yn gorfforol, hyd yn oed yn boenus, a gall arwain at glotiau gwaed, blinder yn y cyhyrau neu friwiau pwyso.
- Mae RCN Cymru wedi tynnu sylw’n gyson at y peryglon sy’n gysylltiedig â derbyn gofal mewn cadair, er enghraifft fel rhan o adroddiad briffio RCN Cymru ym mis Ionawr 2025, ‘Rhoi diwedd ar ofal mewn coridorau yng Nghymru‘
Mae RCN Cymru yn galw ar Lywodraeth nesaf Cymru i:
- Ymrwymo i ddiwygio’r Ddyletswydd Ansawdd i’w gwneud yn ofynnol i Fyrddau Iechyd roi ystyriaeth lawn i faterion sy’n ymwneud â’r gweithlu fel rhan o’u Datganiadau Ansawdd.
- Ychwanegu’r gofyniad i adrodd ar achosion o ofal a ddarperir mewn cadair am dros 24 awr at y ddyletswydd.
Wyddoch chi?:
Mae ymchwil yn dangos bod presenoldeb y nyrs gofrestredig yn lleihau'r risg o niwed i’r claf. Mae pob cynnydd o 10% yn nifer y nyrsys sydd â gradd baglor mewn ysbyty yn gysylltiedig â gostyngiad o 7% mewn marwolaethau cleifion.
The duty of quality
- Part 2 of the Health and Social Care (Quality and Engagement) (Wales) Act 2020 requires the Welsh Government to produce an annual report and lay it before the Senedd setting out how it is “securing improvement in the quality of health services.”
- Health bodies in Wales must also publish a similar “assessment” annually. The Welsh Government is required to provide guidance on the evidence to be used in this assessment and the conduct of such an assessment.
How quality is defined
- The legislation defines ‘quality’ to include the SAFETY of services, the EFFECTIVENESS of services and the EXPERIENCE of service users.
- As the Bill was being developed in 2019, RCN Wales advocated for a wider definition of ‘quality’ to be adopted in the Bill, which would have also included a discussion of WORKFORCE issues. However, this was not reflected in the final draft of the Bill.
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Another problem is that the Act does not require health boards to report on incidences of care in an inappropriate area like on a chair for more than 24 hours.
- Chairs are not designed for continuous use by a patient over an extended period. The experience is physically uncomfortable, even painful, and can lead to blood clots, muscle fatigue or pressure ulcers.
- RCN Wales has consistently highlighted the dangers of receiving care in a chair, for example as part of the January 2025 RCN Wales briefing report, ‘Ending corridor care in Wales’
RCN Wales calls on the next Welsh Government to:
- Commit to amending the Duty of Quality to require Health Boards to give full consideration of workforce issues as part of their Quality Statements.
Did you know?
Research shows that the presence of the registered nurse reduces the risk of patient harm. Every 10% increase in the number of nurses holding a bachelor’s degree in a hospital is associated with a 7% decline in patient mortality.
Arolygiaeth Gofal Iechyd Cymru
Mae Arolygiaeth Gofal Iechyd Cymru (AGIC) yn gyfrifol am arolygu gwasanaethau gofal iechyd i oedolion yng Nghymru. Mae Rhan II, Pennod 4 o Ddeddf Iechyd a Gofal Cymdeithasol (Iechyd Cymunedol a Safonau) 2003 yn rhoi’r pŵer i’r Senedd (y caiff benderfynu ei ddirprwyo i gorff arall) gynnal adolygiadau ac ymchwiliadau i’r ddarpariaeth gofal iechyd gan gyrff GIG Cymru ac ar eu cyfer.
Mae AGIC yn cyflawni ei swyddogaethau ar ran Gweinidogion Cymru ac mae’n rhan o gyfarwyddiaeth o fewn Llywodraeth Cymru. Mae ei hannibyniaeth weithredol a phroffesiynol yn cael ei diogelu gan nifer o fesurau sy’n ei galluogi i roi golwg wrthrychol a chadarn ar wasanaethau sydd, o’u hystyried gyda’i gilydd, yn effeithio ar bron pawb yng Nghymru.
Fodd bynnag, mae “Polisi a chyllidebau ar gyfer Arolygiaeth Gofal Iechyd Cymru ac Arolygiaeth Gofal Cymru” wedi’u rhestru fel un o gyfrifoldebau Jeremy Miles, Ysgrifennydd y Cabinet dros Iechyd a Gofal Cymdeithasol. Mae adroddiad y Pwyllgor Iechyd a Gofal Cymdeithasol yn 2014 yn nodi, “nid yw AGIC yn derbyn llythyr cylch gwaith blynyddol, ac nid yw ychwaith yn cael cyfarfodydd rheolaidd wedi’u trefnu gyda’r Gweinidog Iechyd.”
Problem arall yw nad yw’r ffordd benodol y mae AGIC yn arolygu gwasanaethau yn cael ei nodi mewn deddfwriaeth.
Mae RCN Cymru yn galw ar Lywodraeth nesaf Cymru i:
- Nodi bodolaeth, rôl a chyfrifoldebau AGIC mewn un Ddeddf Senedd Cymru. Fel rhan o hyn, dylid sicrhau bod cyfrifoldebau statudol AGIC yn cael eu hamlinellu mewn un lle, megis: gwella ansawdd gofal ac urddas cleifion a helpu i sicrhau mynediad cyfartal i bawb.
- Ystyried gwneud AGIC yn annibynnol ar Lywodraeth Cymru. Byddai gwneud AGIC yn annibynnol yn gyson â’i sefydliad cyfatebol yn Lloegr, sef y Comisiwn Ansawdd Gofal.
- Ei gwneud yn ofynnol i AGIC newid y ffordd y mae’n arolygu a nodi’r dull arolygu newydd mewn deddfwriaeth. Dylai’r dull arolygu hwn gynnwys ‘parthau’, meini prawf a dangosyddion ansawdd penodol a manwl y caiff gwasanaethau eu mesur yn eu herbyn (yn debyg i’r dull a ddefnyddir gan Arolygiaeth Gofal Iechyd yr Alban), yn ogystal â system sgorio (nifer) a chodau lliw (Rhagorol/Da ac ati) ar gyfer parth a/neu faen prawf ar wahân. Dylai’r dull hwn fod ar gael i’r cyhoedd ac yn hygyrch.
Healthcare Inspectorate Wales
Healthcare Inspectorate Wales (HIW) is responsible for inspecting adult healthcare services in Wales. Part II, Chapter 4 of The Health and Social Care (Community Health and Standards) Act 2003 grants the Senedd the power (which it may decide to delegate to another body) to “[conduct] reviews of, and investigations into, the provision of health care by and for Welsh NHS bodies.”
HIW carries out its functions on behalf of Welsh Ministers and is part of a directorate within the Welsh Government. Its operational and professional independence is “protected by a number of safeguards that enable it to provide an objective and robust view of services that, taken as a whole, affect virtually everyone in Wales.”
However, “Policy and budgets for Healthcare Inspectorate Wales and the Care Inspectorate Wales” are listed as one of the responsibilities of Jeremy Miles, Cabinet Secretary for Health and Social Care. A 2014 Health and Social Care Committee report states that “HIW does not receive an annual remit letter, nor does HIW have regular scheduled meetings with the Health Minister.”
Another problem is that the specific way in which HIW inspects services which is not set out in legislation.
RCN Wales calls on the next Welsh Government to:
- Lay out the existence, role and responsibilities of HIW in a single Act of Senedd Cymru. As part of this, HIW should have its statutory responsibilities outlined in one place, such as: improving the quality of care and patient dignity and helping to ensure equality of access for all.
- Consider making HIW independent from the Welsh Government. Making HIW independent would align with its English equivalent, the Care Quality Commission.
- Require HIW to change its method of inspection and set out the new method of inspection in legislation. This method of inspection should include specific and detailed ‘domains’, criteria and quality indicators against which services are to be measured (similar to the method used by Healthcare Inspectorate Scotland), as well as a scoring (number) and colour-coded rating (Outstanding/Good etc) system for each separate domain and/or criteria. This method should be made publicly available and accessible.
Asiantaethau nyrsio
Beth yw asiantaethau nyrsio ac a ydynt yn cael eu rheoleiddio?
- Mae asiantaethau nyrsio yn darparu staff ar gyfer sefydliadau sydd angen staff gofal iechyd ychwanegol h.y. nyrsys a/neu gynorthwywyr gofal iechyd/gweithwyr cymorth. Gall y ddarpariaeth hon fod ar sail ad hoc (staff o ddydd i ddydd), contract tymor hwy neu ar sail barhaol.
- Deddf Safonau Gofal 2000 yw’r hyn sy’n diffinio “asiantaeth” at ddibenion rheoliadau asiantaethau nyrsio. Yna diwygiwyd y diffiniad hwn gan Ddeddf Rheoleiddio ac Arolygu (Cymru) 2016 i hepgor asiantaethau nyrsio.
- Yn 2019, rhoddodd Arolygiaeth Gofal Cymru y gorau i reoleiddio asiantaethau nyrsio (ac eithrio’r rhai sy’n darparu gofal cartref). O ganlyniad, nid yw asiantaethau nyrsio yn cael eu rheoleiddio yng Nghymru mwyach, ac eithrio’r rhai sy’n darparu gofal cartref.
- Mae asiantaethau nyrsio yn cael eu rheoleiddio o dan Adran 47 o Ddeddf Diwygio Gwasanaethau Cyhoeddus (Yr Alban) 2010. Mae asiantaethau nyrsio yng Ngogledd Iwerddon yn cael eu rheoleiddio o dan Reoliadau Asiantaethau Nyrsio (Gogledd Iwerddon) 2005. Mae asiantaethau nyrsio yn cael eu rheoleiddio yn Lloegr o dan Reoliadau Asiantaethau Nyrsio 2002.
Problemau
- Mae’r ffaith nad yw asiantaethau nyrsio yn cael eu rheoleiddio yng Nghymru yn golygu nad ydynt yn cael eu monitro ar gyfer safonau o ran diogelwch, ansawdd y gwasanaethau, dogfennaeth hawl i weithio, hyfforddiant a phrofiad staff, nac ar gyfer arferion cyflogaeth. Mae’r diffyg monitro hwn yn golygu nad yw camau yn cael eu cymryd pan ddarperir gwasanaethau nad ydynt yn ddigon da.
- Mae RCN Cymru yn deall bod rhai asiantaethau’n ecsbloetio eu gweithlu ac yn caniatáu i weithwyr gofal amhrofiadol weithio mewn lleoliadau risg uchel. Yn ogystal, mae gweithwyr gofal yn gweithio y tu hwnt i’w terfynau hawl i weithio, ac mae yna achosion wedi bod pan nad yw gweithwyr gofal wedi cael eu talu i guddio hyn.
- Mae RCN Cymru wedi clywed tystiolaeth o bobl yn cael eu talu llai na’r isafswm cyflog mewn rhai asiantaethau.
- Mae pryderon diogelu sylweddol, gan gynnwys asiantaethau sy’n cyfaddawdu ar ofynion ar gyfer gwaith fel hyfforddiant addas, h.y. symud a thrin, ynghyd â phrofiad annigonol ym maes gwaith, ac ymgysylltu â gweithwyr nad ydynt wedi gweithio ym maes iechyd neu ofal cymdeithasol o’r blaen.
Mae RCN Cymru yn galw ar Lywodraeth nesaf Cymru i:
- Ddeddfu i reoleiddio asiantaethau nyrsio (yn union fel y mae asiantaethau meddygol yn cael eu rheoleiddio).
Nursing agencies
What are nursing agencies and are they regulated?
- Nursing agencies supply organisations that require additional healthcare staff i.e. Nurses and/or healthcare assistants/support workers. This supply can be on an ad hoc basis (day to day cover), a longer-term contract or on a permanent basis.
- The Care Standards Act 2000 is what defines an "agency" for the purposes of the nursing agency regulations. This definition was then amended by the Regulation and Inspection (Wales) Act 2016 to omit nursing agencies.
- In 2019, Care Inspectorate Wales stopped regulating nursing agencies (except for those that provide domiciliary care). As a result, nursing agencies are no longer regulated in Wales, except for those that are providing domicillomiciliary care.
- Nursing agencies are regulated under Section 47 of the Public Services Reform (Scotland) Act 2010. Nursing agencies in Northern Ireland are regulated under The Nursing Agencies Regulations (Northern Ireland) 2005. Nursing agencies are regulated in England under the Nurses Agencies Regulations 2002.
Problems
- The fact that nursing agencies are unregulated in Wales means that they are not being monitored for standards in terms of safety, the quality of the services, right to work documentation, training and experience of staff, or for employment practices. This lack of monitoring means that action is not taken when sub-standard services are provided.
- RCN Wales understands that some agencies are exploiting their workforce and allowing non-experienced care workers to work in high-risk settings. In addition, care workers are working beyond their right to work limits, and there have been instances of pay being withheld from care workers to conceal this.
- RCN Wales has heard evidence of people being paid below the minimum wage at some agencies.
- There are significant safeguarding concerns, including agencies compromising on requirements for work such as suitable training, i.e. moving & handling, coupled with insufficient experience in the field of work, and engaging workers who have not worked in health or social care previously.
RCN Wales calls on the next Welsh Government to:
- Legislate to regulate nursing agencies (just as medical agencies are regulated).
Byrddau Partneriaeth Rhanbarthol
- Mae Byrddau Partneriaeth Rhanbarthol wedi cael rôl ganolog wrth fwrw ymlaen â’r agenda integreiddio yng Nghymru; mae cynllun hirdymor Llywodraeth Cymru ar gyfer iechyd a gofal cymdeithasol, ‘Cymru Iachach’, yn disgrifio Byrddau Partneriaeth Rhanbarthol fel rhai sy’n ‘chwarae rhan gref yn goruchwylio ac yn cydlynu’ wrth sicrhau newid.
- O ystyried y rôl ganolog hon, dylai’r proffesiwn nyrsio gael ei gynrychioli ar y Byrddau Partneriaeth Rhanbarthol gyda chyfranogiad Cyfarwyddwyr Gweithredol Nyrsio. Mae’n annerbyniol, naw mlynedd ar ôl i Fyrddau Partneriaeth Rhanbarthol gael eu sefydlu, nad oes gan y gweithlu nyrsio, sy’n darparu llawer o’r gofal a’r gefnogaeth maent yn eu cynllunio, fewnbwn i benderfyniadau o hyd.
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Mae RCN Cymru o’r farn bod yn rhaid i aelodaeth Byrddau Partneriaeth Rhanbarthol gael ei hehangu i gynnwys:
- Cynrychiolwyr undebau llafur
- Cyrff proffesiynol
- Cyfarwyddwyr nyrsio gweithredol
- Gwasanaethau nyrsio cymunedol
Mae hepgor y rhanddeiliaid hyn yn cyfyngu ar ymgysylltiad y Byrddau, yn cyfyngu ar y mynediad sydd ganddynt i wybodaeth ac, o ganlyniad, yn cyfyngu ar yr hyn y gallant ei gyflawni. Byddai ehangu’r aelodaeth i’w cynnwys yn cryfhau Byrddau Partneriaeth Rhanbarthol yn sylweddol.
- Mae cyfarwyddwyr nyrsio yn atebol am yr holl ofal nyrsio a ddarperir yn eu hardal bwrdd iechyd lleol, gan gynnwys gofal nyrsio yn y sector gofal cymdeithasol. Dylid sicrhau bod rôl y cyfarwyddwr nyrsio yn cael ei nodi’n gwbl glir, a dylid rhoi aelodaeth o’r Byrddau Partneriaeth Rhanbarthol iddynt. Bydd hyn yn sicrhau bod ganddynt y pŵer sydd ei angen i sicrhau ansawdd y gofal a gomisiynir yn eu bwrdd iechyd lleol ac i gyflawni eu cyfrifoldebau.
- Nid oes gan nyrsio cymunedol unrhyw ffordd o roi mewnbwn i’r penderfyniadau a wneir gan Fyrddau Partneriaeth Rhanbarthol fel y’u strwythurir ar hyn o bryd, er gwaethaf y ffaith eu bod yn ymwneud yn sylweddol â darparu’r gwasanaethau a gynllunnir ar lefel y Bwrdd. Mae hyn yn annerbyniol.
Cliciwch yma i gael rhagor o wybodaeth am safbwyntiau polisi RCN Cymru ar Fyrddau Partneriaeth Rhanbarthol.
Regional Partnership Boards
- Regional Partnership Boards (RPBs) have been given a central role in progressing the integration agenda in Wales; the Welsh Government’s long-term plan for health and social care, ‘A Healthier Wales’, describes RPBs as having a ‘strong oversight and co-ordinating role’ in delivering change.
- Given this central role, nursing should be represented on the RPBs with the involvement of the Executive Directors of Nursing. It is unacceptable that nine years into their existence RPBs still lack decision input from the nursing workforce delivering much of the care and support they plan.
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RCN Wales believes the membership of RPBs must be expanded to include:
- Trade unions representatives
- Professional bodies
- Executive nurse directors
- Community nursing services
Omitting these stakeholders limits RPBs’ engagement, limits their access to intelligence, and consequently limits what they can achieve. Expanding the membership to include them would strengthen RPBs significantly.
- Nurse directors are accountable for all nursing care provided within their local health board area including nursing care in the social care sector. The role of the nurse director should be made explicitly clear, and they should be granted membership on the RPBs. This will ensure they have the power needed to ensure the quality of care commissioned in their local health board and fulfil their responsibilities.
- Community nursing has no way to input into RPB decision-making as currently structured, despite being significantly involved in the delivery of services planned at RPB level. This is unacceptable.
Read more regarding RCN Wales policy positions on RPBs.
Gofal sylfaenol
Mae nyrsys cofrestredig a gweithwyr cymorth gofal iechyd sy’n gweithio ym maes gofal sylfaenol yn cael eu cyflogi’n bennaf gan feddygon teulu. Mae amrywiaeth eang o gymwysterau, profiad a rolau a gyflawnir gan nyrsys cofrestredig a gyflogir gan feddygon teulu. Gall nyrsys cofrestredig, gyda’r addysg a’r hyfforddiant priodol, weithio fel uwch-ymarferwyr nyrsio, nyrsys sy’n rhagnodi’n annibynnol, arbenigwyr nyrsio a nyrsys ymgynghorol.
Mewn meddygfeydd, bydd llawer o gleifion yn gweld nyrs y practis ac yn cael eu trin a’u cynghori ganddi. Mae nyrsys cofrestredig yn ymgymryd ag ystod enfawr o asesiadau ac ymyriadau, o imiwneiddio i reoli cyflyrau hirdymor. Gall nyrsys cofrestredig drin mân anafiadau, cynorthwyo gyda mân lawdriniaethau o dan anesthetig lleol, arwain gofal cleifion wrth reoli cyflyrau hirdymor a rhoi’r gorau i ysmygu, rhedeg rhaglenni brechu a chlinigau sytoleg ceg y groth a llawer mwy.
Mae nyrsio gofal sylfaenol yn cynnig ateb credadwy i uwchraddio’r agendâu optimeiddio atal iechyd a chyflyrau hirdymor, gwella mynediad, cefnogi’r agenda gofal yn agosach at adref a gwella ansawdd bywyd pobl Cymru wrth wneud hynny.
Ym mis Mawrth 2025, ymatebodd Coleg Nyrsio Brenhinol Cymru i ymchwiliad y Pwyllgor Iechyd a Gofal Cymdeithasol, sef Dyfodol meddygaeth deulu yng Nghymru. Gellir dod o hyd i’n hymateb llawn yma. Argymhellodd RCN fod Llywodraeth Cymru yn cymryd y camau canlynol i wella gwasanaethau gofal sylfaenol:
1. Gwasanaethau gofal sylfaenol sy’n ymateb i anghenion lleol
- Dylai Llywodraeth Cymru sicrhau bod gwasanaethau gofal sylfaenol yn cael eu darparu yn seiliedig ar anghenion y boblogaeth 24 awr y dydd, 7 diwrnod yr wythnos.
- Gallai Llywodraeth Cymru hefyd ystyried agor contractau gwasanaethau meddygol cyffredinol (GMS) fel y gall nyrsys gynnig i ddarparu gwasanaethau gofal sylfaenol fel contractwyr annibynnol.
- Dylai Llywodraeth Cymru helpu i feithrin system atgyfeirio integredig, lle mae cyfathrebu di-dor rhwng practisau cyffredinol a gwasanaethau iechyd eraill y gallai fod angen i glaf gael mynediad iddynt.
2. Buddsoddi mewn Uwch-ymarferwyr Nyrsio a Nyrsys Ymgynghorol i ategu meddygon teulu
- Mae angen niferoedd digonol o swyddi uwch-ymarferwyr nyrsio a nyrsys ymgynghorol ledled Cymru i atgyfnerthu timau gofal sylfaenol a darparu gwasanaethau mwy amserol i’r cyhoedd.
- Dylai Llywodraeth Cymru annog cyflogwyr practisau cyffredinol i gyflogi staff i gyflawni’r rolau hyn, o bosibl drwy’r contract GMS. Fel arall, dylai nyrs allu darparu gwasanaethau gofal sylfaenol fel rhan o’r contract GMS. Yn ogystal, dylai byrddau iechyd ddefnyddio uwch-ymarferwyr nyrsio a nyrsys ymgynghorol fel rhan o’u strategaethau i symud gofal yn agosach at adref.
3. Buddsoddi mewn addysg gofal sylfaenol
- Dylai Addysg a Gwella Iechyd Cymru (AaGIC), yn dilyn cyngor gan RCN a cholegau brenhinol eraill yn ogystal â chan glystyrau gofal sylfaenol, gynyddu addysg gofal sylfaenol arbenigol ar gyfer nyrsys cofrestredig a lleoliadau i fyfyrwyr nyrsio israddedig, gan gynnwys cryfhau’r ddarpariaeth Gymraeg.
Primary care
Registered nurses and health care support workers working in primary care are mainly employed by General Practitioners (GPs). There is a wide range of qualifications, experience and job roles undertaken by registered nurses employed by GPs. Registered Nurses, with the appropriate education and training, can work as advanced nurse practitioners, independent prescribers, nurse specialists and consultant nurses.
Within the GP surgery many patients will see, be advised and treated by the practice nurse. Registered nurses undertake a huge range of assessments and interventions, from immunisations to the management of long-term conditions. Registered Nurses can treat minor injuries, assist with minor operations under local anaesthetic, lead patient care in managing long-term conditions and smoking cessation, run vaccination programmes and cervical cytology clinics and much more.
Primary care nursing presents a credible solution to upscale both health prevention and long-term condition optimisation agendas, improving access, supporting the care closer to home agenda and improving quality of life for the people of Wales in doing so.
In March 2025, the Royal College of Nursing Wales responded to a Health and Social Care Committee inquiry into The future of general practice in Wales. Our full response can be found here. RCN recommended that the Welsh Government takes the following actions to improve primary care services:
1. Primary care services that are responsive to local need
- The Welsh Government should ensure that primary care services are delivered based on the needs of the population across 24 hours, 7 days a week.
- The Welsh Government could also consider opening up general medical services (GMS) contracts so that nurses can bid to provide primary care services as independent contractors.
- The Welsh Government should help foster an integrated referral system, where communication is seamless between general practices and other health services that a patient may need to access.
2. Invest in Advanced Nurse Practitioners and Consultant Nurses to complement GPs
- Adequate numbers of advanced nurse practitioner and consultant nurse posts are needed across Wales to strengthen primary care teams and deliver more timely services for the public.
- The Welsh Government should encourage, potentially through the GMS contract, general practice employers to employ these roles. Alternatively, nurses should be able to provide primary care services as part of the GMS contract. In addition, health boards should deploy advanced nurse practitioners and consultant nurses as part of their strategies to move care closer to home.
3. Invest in primary care education
- Health Education Improvement Wales (HEIW), following advice from the RCN and other royal colleges as well as from primary care clusters, should increase specialist primary care education for registered nurses and undergraduate nursing student placements, including strengthening Welsh language provision.
Iechyd y cyhoedd
Mae’r Gwasanaeth Iechyd Gwladol (GIG) yn wynebu pwysau digynsail, gyda galwadau cynyddol a phoblogaeth sy’n heneiddio sydd ag anghenion mwy cymhleth. Mae anghydraddoldebau iechyd yng Nghymru yn ehangu, mae gan bobl sy’n byw yn ein cymunedau mwyaf difreintiedig ddisgwyliad oes llawer is a chanlyniadau iechyd gwaeth na’u cymdogion mwy cyfoethog.
Nyrsio ym maes iechyd y cyhoedd:
Mae nyrsys cofrestredig ym mhob lleoliad yn chwarae rôl hanfodol wrth wella iechyd y cyhoedd trwy gydol eu bywyd, gan gefnogi unigolion a chymunedau o’r crud i’r bedd. Mae nyrsys iechyd y cyhoedd yn ganolog i’r gwaith hwn. Mae ymwelwyr iechyd a nyrsys ysgol yn darparu cymorth hanfodol yn y blynyddoedd cynnar a thrwy gydol plentyndod. Mae’r gwasanaethau hyn nid yn unig yn diogelu ac yn hyrwyddo iechyd plant a phobl ifanc ond hefyd yn lleihau pwysau hirdymor ar y GIG trwy fynd i’r afael â materion yn gynnar.
Mae anghenion iechyd newidiol y boblogaeth yn her i’r GIG. Fodd bynnag, mae’n her y mae nyrsys iechyd y cyhoedd yn dra chymwys i helpu i fynd i’r afael â hi os bydd Llywodraeth nesaf Cymru yn ehangu ac yn arallgyfeirio rolau nyrsys iechyd y cyhoedd. Byddai hyn yn cynnwys datblygu nyrsys iechyd y cyhoedd arbenigol sy’n canolbwyntio ar feysydd fel iechyd meddwl, heneiddio, a lles cymunedol, gan sicrhau ymyriadau penodol ac effeithiol ar draws cwrs bywyd.
Mae nyrsys lefel uwch a nyrsys ymgynghorol ym maes iechyd y cyhoedd yn darparu arweinyddiaeth strategol wrth ddylunio a darparu gwasanaethau, yn ysgogi integreiddio ar draws iechyd, gofal cymdeithasol, addysg a llywodraeth leol, ac yn creu cyfleoedd ar gyfer ymchwil dan arweiniad nyrsys sy’n dangos effaith ac yn llywio polisi yn y dyfodol. Fodd bynnag, nid oes yr un nyrs ymgynghorol iechyd y cyhoedd yn cael ei chyflogi gan unrhyw un o’r saith bwrdd iechyd.
Atebion:
- Tyfu a chynnal y gweithlu ymwelwyr iechyd a nyrsys ysgolion, gan sicrhau bod capasiti i ateb y galw.
- Ehangu rolau arbenigol mewn meysydd fel iechyd meddwl a heneiddio, fel y gall nyrsys ddarparu ymyriadau wedi’u targedu lle mae eu hangen fwyaf.
- Datblygu swyddi nyrsio lefel uwch ac ymgynghorol sy’n arwain gwasanaethau iechyd y cyhoedd, yn dylanwadu ar bolisi, ac yn ysgogi arloesedd.
- Sicrhau bod gwasanaethau nyrsio iechyd y cyhoedd wedi’u hymwreiddio’n llawn yng ngwaith cynllunio a blaenoriaethu GIG Cymru.
- Buddsoddi mewn blynyddoedd cynnar, iechyd plant, a gwasanaethau nyrsio ysgolion er mwyn adeiladu sylfeini iechyd hirdymor.
- Cefnogi modelau gofal integredig lle mae nyrsys iechyd y cyhoeddus yn gweithio ar draws sectorau i ddarparu dulliau atal, ymyrraeth gynnar, a chymorth cymunedol wedi’i dargedu.
- Galluogi nyrsys iechyd y cyhoedd i arwain a chymryd rhan mewn ymchwil i werthuso effaith ac adeiladu’r sylfaen dystiolaeth ar gyfer gwasanaethau yn y dyfodol.
Rhagor o wybodaeth:
- Ymateb RCN Cymru i ymchwiliad y Pwyllgor Iechyd (2024) i ‘Atal iechyd gwael – gordewdra’
- Ymateb RCN Cymru i Ymgynghoriad y Pwyllgor Iechyd ar Fil Iechyd y Cyhoedd (Cymru)
Public health
The National Health Service (NHS) is facing unprecedented pressures, with increasing demands and an ageing population presenting with more complex needs. Health inequalities in Wales are widening, people living in our most deprived communities have significantly lower life expectancies and poorer health outcomes than their wealthier neighbours.
Nursing in public health:
Registered nurses across all settings play a crucial role in improving public health throughout the life course, supporting individuals and communities from cradle to grave. Public health nurses are central to this work. Health visitors and school nurses provide essential support in the earliest years and throughout childhood. These services not only protect and promote the health of children and young people but also reduce long-term pressures on the NHS by addressing issues early.
The changing health needs of the population poses a challenge to the NHS. However, it is a challenge that public health nursing is well equipped to help address if the next Welsh Government expands and diversifies public health nursing roles. This would include the development of specialist public health nurses focused on areas such as mental health, ageing, and community wellbeing, ensuring targeted and effective interventions across the life course.
Advanced and consultant-level nurses in public health provide strategic leadership in the design and delivery of services, drive integration across health, social care, education, and local government, and create opportunities for nursing-led research that demonstrates impact and informs future policy. However, not a single consultant nurse in public health is employed by any of the seven health boards.
Solutions:
- Grow and sustain the health visiting and school nursing workforce, ensuring capacity to meet demand.
- Expand specialist roles in areas such as mental health and ageing, so nurses can deliver targeted interventions where they are most needed.
- Develop advanced and consultant-level nursing posts that lead public health services, influence policy, and drive innovation.
- Ensure that public health nursing services are fully embedded within NHS Wales planning and prioritisation.
- Invest in early years, child health, and school nursing services to build the foundations of long-term health.
- Support integrated models of care where public health nurses work across sectors to provide prevention, early intervention, and targeted community support.
- Enable public health nurses to lead and participate in research to evaluate impact and build the evidence base for future services.
More information:
- RCN Wales response to the Health Committee inquiry (2024) into ‘Prevention of ill health – obesity’
- RCN Wales response to the Health Committee’s Consultation on the Public Health (Wales) Bill
Page last updated - 25/09/2025
