DECISIONS following Hywel Dda University Heath Board’s recent consultation on nine of its services, which includes 22 alternatives to the initial options proposed, are to take place at a special two-day extraordinary meeting next week.

Last year, the Health Board consulted with its communities on options for change in critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology.

It said its Clinical Services Plan focuses on nine healthcare services that are “fragile and in need of change”.

At the launch of the consultation it said the services, and potential changes at the four main hospitals of Haverfordwest’s Withybush, Carmarthen’s Glangwili, Llanelli’s Prince Philip and Aberystwyth’s Bronglais, would see no changes to how people access emergency care (A&E) or minor injury care as part of the consultation, with an ongoing separate consultation on minor injury care at Prince Philip.

These nine clinical services were selected because of risks to them being able to continue to offer safe, high-quality services, or care in a timely manner, the board has previously said.

The proposed changes, with many different options in each of the nine services across the area, could mean some hospitals gaining or losing services, along with community site options in some cases.

An independent consultation report prepared by Opinion Research Services is part of the information the Board will consider on February 18 and 19; with more than 4,000 questionnaire responses in addition to the feedback shared at public events, staff meetings and stakeholder sessions.

During the consultation, communities shared an additional 190 alternative ideas for the services, which have been narrowed down to 22.

These will be considered alongside the options that were shared during the consultation, with members also considering whether further engagement, or additional information may be required, before a final decision is made.

Of the nine areas, critical care has three options, and one alternative; dermatology four options; emergency general surgery, two options and two alternative; endoscopy, three options and one alternative; ophthalmology, three options and six alternatives; orthopaedics, four options and five alternatives; stroke, two options and two alternatives; radiology, four options and four alternatives; and urology, one option and one alternative.

Dr Neil Wooding, Chair of Hywel Dda University Health Board, said: “At our meeting next week, the Board will carefully consider the consultation feedback alongside the latest clinical evidence, workforce insights, updated impact assessments and the alternative options that were put forward during the consultation.

“Our responsibility is to consider the full range of evidence and ensure we make decisions that ensure that our services are sustainable for the future. No decisions have been made ahead of the Board.

“We are committed to a thorough and transparent process, ensuring each option and alternative options are considered in the round, and focused on improving services for the people who rely on them.”

The first day of the two-day event will be dedicated to reviewing the evidence and considering the options in detail, with decisions on the second.

Unions warn award amounts to real-terms cut as inflation remains above headline figure

NHS staff across Wales will receive a 3.3% consolidated pay increase from April 1, 2026, after the Welsh Government accepted recommendations from the 39th NHS Pay Review Body.

The uplift applies to all staff employed under Agenda for Change terms and conditions, including nurses, healthcare assistants, porters, cleaners and other frontline health workers.

Health and Social Care Secretary Jeremy Miles said the award followed independent economic advice and was above current inflation forecasts issued by the Bank of England and the Office for Budget Responsibility.

He said inflation was expected to fall progressively towards the two percent target by early 2027 and described the settlement as fair and responsible within the current financial climate.

Lowest-paid staff

The Welsh Government confirmed that its commitment to pay the Real Living Wage from April 2026 means the lowest-paid NHS staff will see increases ranging from 3.8% to 5.9%.

However, it was also noted that Bands 1 and 2 and the entry point of Band 3 will remain on the same pay rate from April because the previously announced living wage uplift already exceeds the Pay Review Body recommendation.

Ministers said discussions will continue alongside England and Northern Ireland on structural reforms to the Agenda for Change framework, with any agreed changes backdated to April 2026.

Union anger

The announcement prompted sharp criticism from health unions, who argue that with inflation currently at 4.2%, many staff will still see a reduction in real-terms pay.

The Royal College of Nursing described the award as “very disappointing” and said it falls short of commitments to restore nursing pay to 2008 levels.

RCN Wales Executive Director Helen Whyley said: “At a time when the cost of living remains high another real term pay cut is being imposed again on a workforce already stretched to its limits.”

She also criticised the continued use of the Pay Review Body process after unions had raised expectations of direct negotiations.

Meanwhile, UNISON Cymru said health workers are likely to be angry at what it called “another below inflation pay award”.

UNISON Cymru health committee chair Dawn Ward said some NHS staff were struggling with rising household bills and felt undervalued.

The union has called for Wales to move towards a Scottish-style model of direct pay negotiations between government, employers and unions.

Political pressure

The pay announcement is likely to intensify debate about NHS funding, recruitment and retention across Wales.

While ministers argue the settlement reflects economic forecasts and financial constraints, unions maintain that headline percentages do not reflect the pressures facing frontline staff.

With morale described as fragile and vacancies continuing across Welsh health boards, the dispute is expected to remain politically sensitive in the months ahead.

Calls for “honest leadership” over future of Bronglais, Withybush and South Pembrokeshire

A WEST WALES councillor has accused health chiefs and the Welsh Government of repeatedly failing local communities over the future of hospital services.

Cllr Aaron Carey has issued a public statement calling for what he describes as “honest leadership and 21st-century care” for residents across Ceredigion, Pembrokeshire and Carmarthenshire.

In his statement, Cllr Carey said hospitals including Bronglais Hospital in Aberystwyth and Withybush Hospital in Haverfordwest are “lifelines” that must be strengthened rather than allowed to decline.

He claimed Hywel Dda University Health Board had repeatedly reassured the public that services would be protected, only for those assurances to be weakened or reversed.

“Time and again, residents have been told that no decisions have been made, that services are safe, or that changes are temporary,” he said. “Too often, those words have proven hollow.”

Cllr Carey also referenced long-running uncertainty over proposals for a new “super hospital” in the region, arguing that delays and ambiguity surrounding the project had contributed to what he described as “drift and decline” at Withybush.

He said Bronglais Hospital faces continued pressure, with concerns about staffing levels and the sustainability of key services in rural mid and west Wales.

The councillor further highlighted issues including long ambulance response times, pressures on GP surgeries, reduced community provision and difficulties accessing timely treatment.

Rural communities, he said, should not receive “second-class care”.

South Pembrokeshire Hospital closure

Cllr Carey pointed to the temporary closure of services at South Pembrokeshire Hospital over the Christmas period, which were later reinstated following public pressure and a petition he said he personally presented to the health board.

He claimed that those services were subsequently closed again “without warning or meaningful consultation”.

“This sequence of events speaks volumes about how decisions are being made and how little respect is shown for local voices,” he said.

Call for Welsh Government action

Cllr Carey said Hywel Dda Health Board operates under the oversight of the Welsh Government, which he argued must provide greater intervention and investment.

“We need honesty instead of spin, genuine engagement instead of box-ticking consultations, and a clear commitment to strengthening hospitals like Bronglais and Withybush for the long term,” he said.

In previous statements, Hywel Dda University Health Board has said it faces significant financial pressures and workforce challenges, alongside increasing demand for services across a largely rural region. The board has previously maintained that any changes to services are made with patient safety, sustainability and clinical evidence at the forefront, and that public consultation forms part of its decision-making process.

The Welsh Government has also stated that it continues to invest in NHS Wales, including capital funding for new facilities and improvements in community-based care, while working with health boards to ensure services remain safe and sustainable.