Services Under Review Due to Fragility
According to the Health Board, some services are fragile because clinical teams are dispersed across multiple sites over a wide geographical area.
Hywel Dda University Health Board has heard that proposals for their stroke service have received the "strongest opposition" as they discuss the future of nine clinical services.
The Health Board states that the services under consideration are "fragile" and "cannot continue as they are".
With over 4,000 responses to a survey during the public consultation on the future of the services, discussing the findings and considering options was the main agenda at the extraordinary board meeting on Wednesday.
A final decision on the services is expected on Thursday.
Hundreds Protest to Keep Bronglais Stroke Unit
There has been strong reaction to the possible reorganisation in west Wales hospitals.
Among the nine services facing change are critical care, orthopaedics, and stroke.
The Health Board's aim is to "address service weaknesses, improve standards, and reduce waiting times for people needing diagnosis and treatment".
The final decision, which will affect services across all the board's main hospitals, will consider public consultation responses alongside a wide range of other information.
In recent protests, campaigners have called to retain the stroke unit at Bronglais Hospital.
Currently, stroke units are located at each of the board's four main hospitals: Bronglais in Aberystwyth, Glangwili in Carmarthen, Prince Philip in Llanelli, and Withybush in Haverfordwest.
The two options presented to the public as part of the consultation would reduce the number of stroke units currently available.
This could mean the existing stroke units at Bronglais and Glangwili would become 'treat and transfer' services only, with patients from those hospitals having to travel to Prince Philip or Withybush hospitals for stroke unit care.
The Health Board states both options would "help to recruit more staff" and "improve the service," but local campaign groups such as the Bronglais Services Defence Group oppose the options and have protested to save their unit.
Personal Impact of Potential Changes
Brendan Somers and his wife, Glynis
Two years ago, Brendan Somers suffered a stroke and received treatment in the unit at Bronglais.
According to his wife Glynis, the service was commendable, but the thought of losing the unit and it becoming a 'treat and transfer' service causes her concern.
"It's terrible if they intend to close it, because they've been talking about 'treat and transfer.' When they say treat, they only mean giving the clot buster," she said.
"Everything else, you have to travel miles down to Glangwili or Llanelli or Withybush in Haverfordwest. You have to go in an ambulance and follow the ambulance... Terrible."
Board Meeting Highlights Strong Opposition to Stroke Proposals
During the extraordinary board meeting on Wednesday, members heard that the proposals for the stroke service received the strongest opposition, particularly concerns about timely access, 'golden hour' risks, family access during recovery, and uncertainty about the 'treat and transfer' service.
Other Fragile Services Under Consideration
Eight other services are also considered fragile, including:
- Emergency general surgery
During the meeting, board members heard that similar themes repeatedly arose in consultation responses.
These included concerns about travel, transport, and rural geography, alongside worries that service changes alone would not resolve staffing issues.
The board also heard that public trust and confidence in the process is fragile, with some feeling the process seemed complex and at times decisions appeared pre-made.
Dr Neil Wooding, chair of the health board, said he felt the process had been "an honest one," noting that responses during the consultation period had been "extremely helpful."
He acknowledged the decisions would not be easy, with the board having to manage "a series of tensions."
Consultation responses, alongside a wide range of other information, were discussed in detail.
Future Service Changes Expected
"Some services will have to change," said Olwen Morgan
In an interview with BBC Cymru, Olwen Morgan, one of the assistant nursing directors within Hywel Dda, said:
"As a health board, we want to maintain the best services we can for our population.
"To do that, some of those services will have to change or possibly move to other parts of the health board. But the overall aim will always be to maintain services as close to people's homes and communities as possible.
"But maybe we will have to change which services we provide and where we run them to maintain standards and ensure services survive."
She added that no changes would happen overnight.
"It will take time for us as a health board to realise the agreements and changes, so we will keep in touch with our population and ensure our population and patients know exactly when our services will change and how they will change, but nothing will change overnight."
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