Huw Dylan Owen

Rhamant neu Angen? –

dylanwad iaith ar effeithiolrwydd therapi

Need or Romantic Notion? –

language influence on therapy effectiveness

Ansawdd a Diogelwch

Quality and Safety

Mynediad

Access

GweithluWorkforce

Cost

Cyfaddawd Derbyniol

Acceptable trade-offs

Context

Cyd-destun = polisi, iechyd poblogaeth, nodweddion cymuned, gwasanaethau eraill ac ati.Context = policy, population health, community characteristics, other services etc.

Gofal o Safon Rhyngwladol World Class Health Care

Longley, M. (2012) The Best Configuration of Hospital Services for Wales: A Review of the Evidence. Cardiff: Welsh Institute for Health and Social Care

Cyd-destun

Estimate of the percentage of people 3 years and older who said they could speak Welsh 2001. Electoral Divisions (2003)

Source: 2001 Population Census

“The Welsh language is the curse of Wales. Its prevalence and the ignorance of English have excluded and even now exclude the Welsh people from the civilisation, the improvement, and the material prosperity of their English neighbours. Their antiquated and semi-barbarous language, in short, shrouds them in darkness. If Wales and the Welsh are ever thoroughly to share in the material prosperity, the culture and morality of England, they must forget their isolated language, and learn to speak English and nothing else... For all purposes, Welsh is a dead language.”

- Editorial – The Times (1866)

• Gogwydd Dethol• Cofnodi Dewis Iaith• Effeithiolrwydd Therapi• Barn Defnyddwyr

• Selection Bias?• Recording Language Choice• Therapy Effectiveness• Users’ Opinions

Siaradwyr Cymraeg yr ArdalArea Welsh Speakers

Oed

Age

Nifer

Number

Canran

Percentage

3-4 1,651 41.7%

5-9 6,444 60.5%

10-14 6,889 61.2%

15-24 9,427 49,2%

25-49 23,042 42.4%

50-64 16,457 47.9%

65+ 19,892 59.0%

Gogwydd Dethol? Selection Bias?

0%

20%

40%

60%

80%

100%

694 732 84196 19971

968 1014 83177 13734

Canran Cleifion a Gyfeiriwyd ac a Dderbyniwyd am Adsefydlu oedd yn Siaradwyr Cymraeg i'w gymharu ag Ystadegau Iaith y Sir

Percentage Patients Referred and Accepted for Rehabilitation who were Welsh Speakers in comparison to County Language Statistics

Di-Gymraeg / Non-Welsh SpeakersSiaradwyr Cymraeg / Welsh Speakers

n=1,746

Dengys y prawf Chi-Sgwâr Llwyddiant y Ffit fod gwahaniaeth arwyddocaol yn y gyfran o siaradwyr Cymraeg a gyfeiriwyd ac a dderbyniwyd gan y gwasanaeth adsefydlu am therapi (41.9% a 41.8%) o’i chymharu â’r canran a ragdybiwyd (50.1%),

p<.001.

A chi-square goodness-of-fit test indicates there as a significant difference in the proportion of Welsh speakers referred and accepted by the rehabilitation service for therapy input (41.9% and 41.8%) as compared with the anticipated percentage (50.1%)

p<.001.

Service Users' Language Preference 2010/2011

Percentage Welsh

Speakers Aged 65+ in County - Census 2001 Statistics

Number of Individuals aged

65+ in the county who receive

services paid for by the Local Authority

2010/2011 who have Welsh recorded as

language preference

Number of Individuals aged 65+ in the county who receive services paid for by the Local Authority 2010/2011 who have English or

another language recorded as language

preference

Of those who expressed a preference -

Percentage Individuals aged 65+ in the county who receive care paid

for by the Local Authority 2010/2011

who have Welsh recorded as language

preference

Of those who expressed a preference -

Percentage Indivduals aged 65+ in the

county who receive care paid for by the

Local Authority 2010/2011 who have

English or another language recorded as language preference

Number of Individuals aged 65+ in the county who receive services paid for by the Local Authority 2010/2011

who have no language preference recorded

Percentage of Individuals aged

65+ in the county who receive

services paid for by the Local

Authority 2010/2011 who

have no language preference recorded

Gwynedd 64% 480 1609 23% 77% 0 0%Carmarthenshire 59% 310 607 34% 66% 1542 63%

Ynys Môn 54% 756 1320 36% 64% 1968 49%Cerdigion 54% 223 230 49% 51% 498 52%

Denbighshire 25% 49 916 5% 95% 928 49%Conwy 25% 285 3276 8% 92% 1903 35%

Neath - Port Talbot 22% 133 2423 5% 95% 186 7%Powys 20% 101 1663 6% 94% 1027 37%

Pembrokeshire 19% 105 1201 8% 92% 849 39%Swansea 18% 42 1009 4% 96% 3700 78%Wrexham 16% 98 2496 4% 96% 363 12%Flintshire 10% 19 1541 1% 99% 174 10%Bridgend 9% 1 42 2% 98% 2457 98%

Rhondda Cynon Taf 9% 8 6067 0% 100% 507 8%Merthyr Tudful 8% 4 857 0% 100% 594 41%

Vale of Glamorgan 6% 2 285 1% 99% 1240 81%Cardiff 5% 12 1474 1% 99% 530 26%

Caefphilly 4% 7 5367 0% 100% 2524 32%Monmouthshire 3% 1 450 0% 100% 1063 70%

Torfaen 2% 0 1967 0% 100% 91 4%Newport 2% 0 74 0% 100% 1343 95%

Blaenau Gwent 2% 0 812 0% 100% 322 28%Totals and Averages 20% 2636 35686 7% 93% 23809 38%

Sgorau Cymedrig Amrywiad Asesu a Deilliannau FIM & FAM mewn Ardal gyda Thîm heb Staff sydd yn gallu Siarad Cymraeg

Mean Scores Variation Assessment and Outcome FIM & FAM in Area Team which had no Staff who could Speak Welsh

Cleifion Siaradwyr Cymraeg / Welsh Speaking Patients

Cleifion Di-Gymraeg / Non-Welsh Speaking Patients

0

1

2

3

4

5

6

7

8

9

Sgoriau Cymedrig Amrywiad Asesu a Deilliannau FIM & FAM / Mean Scores Variation Assessment and Outcome FIM & FAM

N=405

The Mann-Whitney U test revealed a significant difference in the FIM & FAM Assessment and Outcome Variation scores of Welsh speakers and non-Welsh speakers in the area where there the team’s staff were non-Welsh-speaking.p<.05

Dengys y Prawf U Mann-Whitney wahaniaeth arwyddocaol yn sgorau Amrywiad Asesu a Deilliannau FIM & FAM siaradwyr Cymraeg a’r di-Gymraeg yn yr ardal lle'r oedd staff y tîm yn ddi-Gymraegp<.05

Gwahaniaeth Sgorau Amrywiad Asesu a Deilliannau / Difference in Variation Score Assessment and Outcome

0

0.5

1

1.5

2

2.5

Sgorau Cymedrig Amrywiad Asesu a Deilliannau Mean Variation Scores Assessment and Outcome

Ardal gyda Thîm o Staff sydd yn gallu Siarad Cymraeg / Area where Team's Staff could speak WelshArdal gyda Thîm heb Staff sydd yn gallu Siarad Cymraeg / Area where Team's could not speak Welsh

Ffordd Ymlaen Way Forward

Gwersi Iaith? Language Lessons?

Codi Hyder Ieithyddol Staff? Raise Staff language confidence?

“It’s not about you!”

Newid diffiniad dewis iaith Change definition of chosen language

“Cynnig Rhagweithiol”Symud y cyfrifoldeb am sicrhau gwasanaethau addas oddi ar ysgwyddau’r defnyddiwr i’r darparwr.

“Active Offer”:Responsibility for ensuring appropriate services transferred from the user to the provider.

Er y ffisig a’r pigiad – y sgan Stethoscôp, chwistrelliad,

Wyddoch chi, ni ddaw iachâd ‘N aml heb iaith cydymdeimlad.