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Critical care crisis: Why Pembrokeshire patients are at risk as Llanelli ICU downgraded

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Prince Philip Hospital whistleblower warns of regional impact as Glangwili faces ICU overflow

A SPECIALIST nurse has spoken out as critical care services at Prince Philip Hospital in Llanelli are quietly scaled back ahead of a public consultation — with direct implications for Pembrokeshire patients who rely on Glangwili Hospital for intensive care.

Hywel Dda University Health Board is preparing to launch a consultation on its Clinical Services Plan, which includes a proposal to formally downgrade the Intensive Care Unit (ICU) at Prince Philip Hospital and replace it with an Enhanced Care Unit (ECU).

However, the transition has already begun. The Herald understands that ICU staff are being reassigned, and patients requiring high-level intensive care are being routinely transferred to Glangwili Hospital in Carmarthen — nearly 24 miles away — despite no final decision having been made.

One senior nurse at the hospital told The Herald: “Staff are being moved off the unit. There are people who need ICU beds but have to wait, as there are none now here. Everyone who needs one has to be transferred to Glangwili.”

The ICU at Glangwili is under significant pressure (Image: File)

She continued: “They could have bleeds, they are not stable. Not only that, but if they need to be transferred between hospitals, that is done by a specialist NHS service based in Cardiff – the Adult Critical Care Transfer Service (ACCTS), part of EMRTS Cymru. We call them ACCTS. When we sign the paperwork, we can see the Health Board is paying around £6,000 per patient for each transfer. The transport is carried out in a specialist ambulance, including an anaesthetist, doctor, and critical care team, to ensure patient stability during transfer. It’s not cheap.”

The nurse also claimed that there are enough skilled staff locally to continue providing intensive care, but the team is being broken up. “We are a specialised team, and we are being dispersed. The people of Llanelli are being put at risk. For what? To save money.”

She said patients from Llanelli were now overwhelming beds in Carmarthen, leaving Glangwili Hospital with little capacity for new cases. “Everyone now down at Glangwili are people with Llanelli area postcodes. They should be being treated here near their family, loved ones. And now down in Carmarthen they are chocker – no room to accept new patients, which is going to impact on patients further west into Pembrokeshire.”

This concern is echoed in Pembrokeshire, where Withybush General Hospital still technically retains seven ICU beds. However, ongoing staff shortages and the discovery of unsafe RAAC concrete have meant that many patients requiring critical care from Pembrokeshire are already being transferred to Glangwili. Now, with Llanelli patients added to the demand, access to critical care is under further pressure across the region.

Costly specialist ambulances from Cardiff are used to transport ICU patients between Llanelli and Carmarthen hospitals (Image: NHS)

Hywel Dda University Health Board is expected to launch a 12-week public consultation on its Clinical Services Plan this week, with options that could lead to permanent reconfiguration of hospital services across Carmarthenshire, Pembrokeshire, and Ceredigion. However, documents seen by The Herald confirm that changes such as the ICU downgrade may proceed before consultation results are finalised.

Appendix 7.55 of the Clinical Services Plan states: “We recognise that the need to respond to service fragility may mean some service change and investment decisions are required ahead of any final reconfiguration, and these will be developed with service, operational and executive leadership.”

Another section of the Plan notes: “Due to the nature of service provision across Mid and West Wales, it is recognised that a wide range of services have some fragilities. This was a key driver behind the development of the Health Board’s strategy which seeks to reduce, if not eliminate, the risks to sustainable service provision.”

Hywel Dda University Health Board’s Medical Director: Mark Henwood (Image: HDUHB)

Commenting directly, Hywel Dda University Health Board’s Medical Director, Mark Henwood, said: “There has been a temporary change in place for critical care services at Prince Philip Hospital since July 2022. This was approved by the Board because of an inability to safely staff two critical care units with Consultant staff in Carmarthenshire providing care to the most unwell patients. This has meant that the sickest patients have been stabilised and transferred mostly to the Critical Care Unit at Glangwili Hospital.

“The temporary change was needed to improve our ability to safely deliver our critical care services in Carmarthenshire with the staffing available.

“We launched our Clinical Services Plan consultation at our Board Meeting today and Critical Care is one of the services which we will be looking at.

“In the consultation, options A and B propose having fewer intensive care units, and Option C proposes maintaining the current temporary arrangement at Prince Philip Hospital, where the sickest patients are transferred to Glangwili intensive care unit.

“In all options, bringing specialist critical care consultants together onto fewer sites would make the service more sustainable, improve safety, and help meet quality standards for our patients.”

However, critics argue that the Health Board’s response amounts to a technocratic justification that fails to meaningfully address community impact, consultation integrity, or patient safety.

Lee Waters MS: “You can’t run a consultation while services are being stripped away”

Lee Waters MS: The people of Llanelli deserve proper, local access to intensive care

Commenting, Llanelli’s Member of the Senedd, Lee Waters, told The Herald: “It looks very much like decisions about critical care at Prince Philip Hospital are being made before the public’s had a real say—just like we saw with the overnight closure of the Minor Injuries Unit. That’s not how you build trust. The people of Llanelli deserve proper, local access to intensive care, and I’m not convinced the Health Board has a credible plan to deliver that. I’ve always tried to be reasonable about change, but in this case the case simply hasn’t been made. You can’t run a meaningful consultation while services are being quietly stripped away.”

Dame Nia Griffith MP: “This erosion of services by the backdoor has got to stop”

Commenting, Llanelli’s MP, Dame Nia Griffith, said: “I am extremely concerned to hear reports of intensive care services at Prince Philip Hospital being scaled back, because people in Llanelli should be able to access this care here, and not see loved ones taken all the way to Glangwili for services that have hitherto been provided in Llanelli.

“Moreover, the fact that this is happening without there having been any consultation, or even any mention of this, completely undermines trust in the Health Board. I will be seeking an urgent meeting with Hywel Dda health board bosses to seek clarification, and make it absolutely clear to them that they must recognise the need for these services in Llanelli and design their staffing model accordingly, with full teams of appropriately qualified staff based here.

“Everyone knows that they are already struggling for space in Glangwili so it makes no sense to be sending more Llanelli patients up there, and on top of that, there is the cost of transporting patients, the discomfort for the patients and the anxiety and inconvenience for the family. This erosion of services by the backdoor has got to stop.”

Welsh Conservatives: “Declare a health emergency”

Commenting, a Welsh Conservative spokesperson said: “The downgrading of ICU services at Prince Philip Hospital before public consultation is unacceptable and undermines trust in the health system.

“The Welsh NHS is in crisis under Labour, with over 10,000 patients waiting more than 12 hours in A&E and two-year waits still unacceptably high, the Welsh Labour Government continues to fail our communities.

“The Welsh Conservatives would declare a health emergency, directing the resources and the entire apparatus of government at the health service, ensuring timely access to care and restoring faith in our Welsh NHS.”

Sam Kurtz, Senedd Member for Carmarthen West and South Pembrokeshire added: “If any decisions are taken before the consultation has concluded, then both the Health Board and the Welsh Labour Government must be prepared to justify them to a deeply concerned public.

“Recruitment has long been a challenge, one that has only worsened under the shadow cast by ongoing uncertainty over the future of healthcare in West Wales.

“That uncertainty stems from the Welsh Labour Government’s continued drive to centralise services, often to the detriment of rural communities.”

Kurtz added: “Access to critical healthcare should never be a postcode lottery.”

Campaigners: ‘Not acceptable – and a shock’

Shocked: Hospital campaigner Cllr Deryk Cundy was not consulted, he said (Image: BBC)

Chair of the SOSPPAN campaign group, Councillor Deryk Cundy, told The Herald that they had raised concerns with Hywel Dda over “rumours from a separate source” suggesting changes to intensive care were already under way — before any formal decision by the Health Board.

“We have not been directly contacted about these changes,” he said. “SOSPPAN has been working closely with Hywel Dda trying to find a way forward — recommending a merger of the Minor Injuries Unit and Same Day Emergency Care, operating 16 hours per day, with increased mental health cover available in Llanelli 24/7.”

He said that when combined with the existing 24-hour Acute Medical Assessment Unit, this could improve service delivery in Llanelli and reduce pressure on Glangwili Hospital. However, he described the ICU downgrade as “a shock” and “not acceptable”.

“For too long, Hywel Dda management have said departments are unsafe and instead of making them safe, they shut them down — only to reopen them 20 miles away. We will be asking for an early meeting with the Health Board, and if these proposals are confirmed, we will express our determination to prevent any further reductions in service at Prince Philip Hospital.”

 

Health

Decision pending on adult mental health referral pathway

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HYWEL DDA University Health Board will decide next week whether to make changes to the GP referral pathway for routine adult mental health services permanent.

The decision will be taken at a public Board meeting on Thursday (Mar 26).

Board members will consider a proposal to formalise changes already introduced in Ceredigion and, if approved, roll out the revised pathway across Pembrokeshire and Carmarthenshire.

Since March 2025, adults in Ceredigion seeking routine mental health support have been advised by their GP to contact the NHS 111 Wales ‘Press 2’ service, rather than being referred directly to the county’s Community Mental Health Team.

The temporary change was introduced in response to ongoing staffing shortages. Health Board officials say the approach has helped maintain timely access to face-to-face assessments for those who need them, while directing initial contact through a single access point.

The 111 ‘Press 2’ service provides telephone assessments by local wellbeing practitioners, supervised by registered mental health nurses, offering advice, support and onward referrals where required.

At its November 2025 meeting, the Board agreed to extend the temporary pathway until the end of March 2026. A nine-week engagement exercise followed, running from December 8 to February 9, to gather feedback from patients, professionals and stakeholders on the potential long-term impact.

Andrew Carruthers, Chief Operating Officer at Hywel Dda University Health Board, said: “I would like to thank everyone who took the time to share their views and experiences.

“I would also like to thank West Wales Action for Mental Health for supporting engagement with patients, including those with lived experience, alongside GPs, primary care teams, mental health staff and third sector partners.

“Our priority is to ensure mental health services remain accessible, fair and sustainable. The temporary changes in Ceredigion have shown some positive benefits, and the feedback we have received from across the three counties will play an important role in shaping the Board’s decision.”

The Board will review all evidence and feedback before making a final decision on the future of the adult mental health referral pathway.

GPs will continue to refer patients with urgent or complex needs directly to community mental health teams where appropriate, and have access to a dedicated NHS 111 professional line for additional clinical advice.

Further details, including the full Board papers, are available here:
https://biphdd.gig.cymru/amdanom-ni/eich-bwrdd-iechyd/cyfarfodydd-y-bwrdd-2026/agenda-a-phapuraur-bwrdd-26-mawrth-2026/

The meeting will be streamed live from 9:30am on Thursday (Mar 26) via:
www.youtube.com/hywelddahealthboard1

 

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Health

Parents urged to check children’s vaccinations after meningitis cases

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Local pharmacy reports MenB vaccine shortage amid rising concern

PARENTS and carers across west Wales are being urged to check their children’s vaccination status following recent meningitis cases in the UK.

The warning comes as a local pharmacy has confirmed a shortage of the Meningitis B (MenB) vaccine, highlighting growing pressure on supplies.

Mendus Pharmacy said it currently has no availability of the vaccine due to what it described as a nationwide supply issue.

Mendus Pharmacy: No availability of the vaccine

In a statement, the pharmacy said: “We would like to inform our patients that, due to ongoing supply issues, we currently have no availability of the Meningitis B vaccine.

“Unfortunately, this is a nationwide shortage and all stock is currently unavailable.

“We understand this may be particularly concerning given the recent outbreak reported in Kent, and we completely appreciate the importance of timely vaccination.”

The pharmacy confirmed it is operating a waiting list and will contact patients once supplies return.

Health officials say keeping vaccinations up to date remains one of the most effective ways to prevent serious illness and reduce pressure on NHS services.

Dr Ardiana Gjini, Executive Director of Public Health at Hywel Dda University Health Board, urged parents to act.

She said: “Vaccination is one of the most effective ways we can protect children and young people from serious illness.

“Ensuring your child is fully vaccinated not only safeguards their health but also helps prevent the spread of infections within our communities.

“I strongly encourage all parents and carers to check their child’s vaccination status. If you are concerned that your child may have missed routine vaccinations, please speak to your GP.”

Meningococcal disease is a serious and potentially life-threatening infection that can lead to meningitis or septicaemia. While many people recover, some are left with long-term physical, neurological or psychological complications. Around one in ten cases can be fatal.

Although the disease can affect anyone, babies, young children, teenagers and young adults are at greatest risk.

In Wales, vaccines protecting against meningococcal strains A, B, C, W and Y are offered as part of the NHS immunisation programme. Infants receive the MenB vaccine, while teenagers are offered the MenACWY vaccine.

Latest figures from the Health Board show that uptake among 16-year-olds for the MenACWY vaccine stands at 76.4%, meaning a significant number of young people remain unprotected as they approach adulthood.

For younger children, uptake of the MenB vaccine is higher but still below the recommended 95% target. Around 92.8% of infants are vaccinated by their first birthday, rising slightly to 91.8% by their second.

Health officials say these figures reflect strong engagement from families and primary care teams but stress that continued vigilance is needed.

Families are being advised to check their child’s vaccination record with their GP or by contacting the Health Board directly. Parents should also ensure babies receive their scheduled MenB doses and that teenagers receive their MenACWY and 3-in-1 booster vaccines, which are currently being delivered in schools.

Parents are also urged to remain alert to the symptoms of meningitis and septicaemia and to seek urgent medical advice if they have concerns.

Further information on symptoms is available via NHS 111 Wales.

 

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Health

NHS ‘on brink of collapse’ during Covid as inquiry exposes failures

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Wales warned to act fast as damning report reveals staff trauma, delayed care and deadly gaps

THE UK’s healthcare system came perilously close to collapse during the Covid-19 pandemic, a major public inquiry has found, with Wales now facing pressure to act on urgent recommendations.

A landmark report published on Thursday (Mar 19) lays bare the scale of the crisis, concluding that hospitals across the UK – including in Wales – were pushed to “intolerable strain”, with some patients receiving lower levels of care and others left untreated altogether.

The findings come as First Minister Eluned Morgan welcomed the report and confirmed the Welsh Government will respond within six months.

Flawed response: Investigators identified serious failings in how the pandemic was handled

System “ill-prepared” for pandemic

The inquiry found the UK entered the pandemic in a weakened state, with staff shortages, too few hospital beds, and ageing infrastructure already placing pressure on services.

Healthcare systems “coped, but only just,” the report states, warning that collapse was only avoided due to the “almost superhuman efforts” of NHS staff.

Many workers suffered severe mental health impacts, with burnout and post-traumatic stress widespread across the workforce.

Patients died alone

Among the most distressing findings was the impact of strict hospital visiting rules.

Thousands of patients died without family by their side, while relatives were often forced to say goodbye over the phone or by text.

The report highlights how restrictions, though intended to save lives, caused lasting trauma for families across Wales and the UK.

Covid-19: Healthcare systems “coped, but only just,” the report states

Missed treatment and cancer delays

The inquiry also exposes the devastating knock-on effect on non-Covid care.

Planned operations were cancelled, screening programmes paused, and patients avoided hospitals out of fear – leading to delayed diagnoses and, in some cases, avoidable deaths.

Cancer treatment performance worsened, with late diagnoses contributing to increased mortality.

“Fundamental flaws” in response

Investigators identified serious failings in how the pandemic was handled, including:

  • Early guidance that underestimated airborne transmission
  • Shortages of PPE, leaving staff exposed
  • Poor communication with vulnerable patients
  • Inadequate planning for emergency and critical care capacity

These issues, the report says, put both patients and staff at greater risk.

Ambulances overwhelmed: The report warns future pandemics could see similar failures unless urgent reforms are made

NHS 111 and ambulances overwhelmed

Emergency systems also struggled to cope.

Demand for NHS 111 surged beyond capacity, while ambulance delays increased – even for life-threatening calls.

The report warns future pandemics could see similar failures unless urgent reforms are made.

Long Covid and hidden impact

The long-term effects of Covid are still being felt, with inconsistent care for Long Covid patients and ongoing uncertainty around treatment.

Meanwhile, millions of people who needed routine care remain affected by the backlog created during the pandemic.

Eluned Morgan: Acknowledged the significant impact on patients, staff and families

Welsh Government response

First Minister Eluned Morgan said the Welsh Government would respond “openly and constructively” to the findings.

She acknowledged the significant impact on patients, staff and families and confirmed Wales will address the inquiry’s recommendations within the required six-month timeframe.

Urgent warnings for the future

The inquiry makes ten key recommendations, including:

  • Expanding hospital and emergency capacity
  • Improving infection control guidance
  • Strengthening support for healthcare workers
  • Better data systems to identify vulnerable patients

It warns that without action, the NHS may not withstand the next pandemic.

“We may not be so lucky next time”

In one of the report’s starkest conclusions, Baroness Hallett warned that healthcare systems came dangerously close to failure.

If the crisis had lasted longer – or hit harder – the NHS could have collapsed entirely.

The message is clear: Wales and the UK must prepare now, or risk repeating the same mistakes.

 

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