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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

‘Children spending more time in digital worlds than the real one’

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CHILDREN are spending more time in digital worlds than the real one, the Senedd has heard, with excessive screen use shaping behaviour and health in ways society cannot ignore.

Labour’s John Griffiths expressed concerns about the impact of smartphones and online gaming on young people amid an “epidemic of screen use” in Wales.

Mr Griffiths titled the debate “Locked in, Bruh!” – “the state of playing a video game while oblivious to anything else” – on the suggestion of Tom, a teenager from Newport.

He raised research from the Centre for Social Justice, a thinktank, which estimates that up to 814,000 UK children aged three to five are already engaging with social media.

The Newport East Senedd Member told the chamber two-thirds of primary school pupils in Wales have their own smartphone by the age of 11.

Mr Griffiths said boys spend two hours more a day on online gaming while girls spend more time on social media and “reel scrolling” which has been linked to damaging self-esteem.

He told Senedd Members: “Boys are becoming more short-tempered and violent when exposed to violent video games and there is, rightly, much concern that children in more deprived families are particularly vulnerable.”

Mr Griffiths, who was first elected in 1999 and will stand down in 2026, said children aged five to 16 spend at least six hours a day looking at a screen. He added that for children, aged 11 to 14, that figure rises to nine hours a day.

He pointed to research showing more than 70% of young people in the UK do not undertake an hour of physical activity a day yet have at least six hours to spend looking at a screen.

He said: “Children are sat inside with a screen at the end of their nose and are not spending time outside enjoying their local communities or playing and interacting with friends.”

Mr Griffiths warned of increasing levels of obesity and rising numbers of young people reporting vision problems, with one in three children globally now short-sighted.

He told the Senedd: “As for the mental health and wider social impacts, anxiety and depression are increasingly linked to excessive screen use as is sleep disruption – with social media interfering with rest and emotional development.”

He raised a New Zealand study of more than 6,000 children that found a correlation between excessive screen time and below-average performance in literacy and numeracy. He warned children have increasingly shortened attention spans and an inability to concentrate.

Mr Griffiths shared the case of his constituent, Danielle, who said her son becomes more aggressive and snappier after a significant time gaming. Lucy, another constituent, explained how her children find the endless reels on social media addictive.

“Once they start scrolling, it’s hard to break that cycle,” the Senedd Member said. “And when she and her husband take the devices away, it often results in tantrums and tears.”

Mr Griffiths raised the example of countries such as Australia, France and Italy which have introduced strict age checks and bans on social media for under 16s.

He acknowledged such a policy would need to come from the UK Government because powers over internet services are not devolved. But he said Wales has the authority to introduce measures through education policy on, for example, smartphones in schools.

The Tories’ Sam Rowlands warned algorithms are having a “sickening” effect on teenagers who are eight times more likely to act on self-harm urges when exposed to such content. “TikTok users with eating disorders receive over 4,000% more toxic content,” he warned.

Responding to Wednesday’s (December 17) debate, Jane Hutt recognised how so-called doom scrolling can have a detrimental impact on young people.

Wales’ social justice secretary said: “We are living through profound change. Childhood today is shaped by technology in ways that were unimaginable a generation ago… For many young people, screens, smartphones and online gaming are part of everyday life.”

Jane Hutt, secretary for social justice, trefnydd and chief whip
Jane Hutt, secretary for social justice, trefnydd and chief whip
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Health

New research centre launched to tackle historic gender health gap in Wales

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A NEW £3m research centre has been launched to tackle long-standing health inequalities faced by women in Wales.

The Women’s Health Research Centre – the first of its kind in Wales – aims to close the historic gender health gap by strengthening investment in women’s health research and improving representation in clinical trials.

The centre was launched to mark the first anniversary of the Women’s Health Plan for Wales, with First Minister Eluned Morgan and Minister for Mental Health and Wellbeing Sarah Murphy visiting staff, researchers and community partners involved in the project.

Led by Women’s Health Research Wales, the centre brings together researchers, NHS organisations, industry, policymakers and communities to develop more effective treatments and ensure health services meet women’s needs throughout their lives.

Its work will cover prevention, early-onset conditions, rare diseases and care for under-served communities.

Projects currently in development include research into symptom-reporting tools to improve the management of conditions such as diabetes, heart failure and chronic obstructive pulmonary disease – areas where the specific impact on women has historically been under-researched.

Researchers are also examining the potential health effects of chemicals used in menstrual products, how best to support young people to stay active during periods, and improved care pathways for people with polycystic ovary syndrome to reduce the risk of developing diabetes and heart disease later in life.

Other projects focus on fertility, including a decision-making tool for women with kidney disease who are considering having children.

One study is working directly with women undergoing fertility treatment to understand why the process can lead to mental health conditions such as post-traumatic stress disorder, with the aim of producing guidance to support trauma-informed fertility care.

First Minister Eluned Morgan said: “I am passionate about improving women’s healthcare. To do that, we must invest in research to gather the evidence we need.

“I am delighted to see how the Welsh Government’s £3m investment, through Health and Care Research Wales, is supporting research based on the experiences of women. This will result in better care and better health outcomes for women.

“This innovative new research centre is a key part of the Women’s Health Plan and will help us better understand women’s experiences. It will lead to more effective treatments and ensure our health service delivers improved outcomes for women in Wales.”

Sarah Murphy, Minister for Mental Health and Wellbeing, said the early progress had been encouraging.

“I’m thrilled the investment we’ve made in this research centre is already delivering projects in such important and under-researched areas of women’s health,” she said.

“The pioneering work I’ve heard about today – including the impact of infertility on women’s mental health – is exactly what we want the Women’s Health Plan to influence and deliver.

“All of this has been achieved in the first 12 months, and I look forward to seeing what can be delivered over the next year.”

Debbie Shaffer, founder and director of Fair Treatment for the Women of Wales and chair of the Women’s Health Wales Coalition, said partnership working would be key to success.

“Research into health issues experienced by women throughout the life course is vital,” she said.

“By working co-productively, in partnership with women and communities, we have a real opportunity to reduce health inequalities and improve treatment options and support.

“We look forward to helping create more opportunities for people with lived experience – whose voices may not have been heard before – to get involved.”

The Women’s Health Plan for Wales was published in December 2024 and sets out a 10-year approach to improving health outcomes for women, ensuring they are listened to and their health needs properly understood.

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Health

Welsh Government intervenes as Gwent health board’s finances ‘deteriorate rapidly’

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THE WELSH Government has escalated intervention at Aneurin Bevan University Health Board to one step short of special measures, amid concerns about an £18m deficit and A&E failures.

Jeremy Miles, Wales’ health secretary, announced the Gwent health board will move to level four for finance and emergency care on the government’s five-point scale.

In an update on escalation at each NHS organisation in Wales, Mr Miles warned the health board’s financial position has “deteriorated rapidly” over the past year.

“It is forecasting an £18.3m deficit by the end of March. This is not acceptable,” he said, announcing he will revoke approval of the health board’s three-year plan.

Mr Miles said the health board had been at level three due to concerns about emergency care at the Grange hospital in Cwmbran but will move to level four.

He told the Senedd: “The health board has failed to deliver the required improvements… This will result in direct intervention by the Welsh Government… to improve the timeliness and quality of urgent and emergency care for people living in the Gwent region.”

Mr Miles announced Betsi Cadwaladr Health Board, in north Wales, would remain at level five or special measures. He pointed to interventions including a review of planned care, cancer and emergency services as well as an investigation into management of waiting times data.

But he raised “considerable” progress on governance and leadership at Hywel Dda Health Board following the appointment of a new chair and chief executive.

He announced Hywel Dda will be de-escalated to routine, level-one arrangements for governance and leadership. However, the west-Wales health board remains at level three for planned care and cancer as well as level four for finance and A&E performance.

He told Senedd members he was appointing a “senior turnaround director” to provide support to Cardiff and Vale Health Board, which was placed into level four in July.

Mr Miles said the escalation levels of Cwm Taf Morgannwg, Swansea Bay and Powys health boards, as well as other NHS bodies such as the ambulance services trust, will not change. All seven health boards in Wales remain in some form of escalated status.

In today’s (December 16) statement, Mr Miles said long waits are falling as he pointed to a 43% reduction in lost ambulance hours since the last six-monthly update in July.

But James Evans, the Conservatives’ shadow health secretary, questioned whether intervention is delivering meaningful improvements for patients and staff.

Conservative MS James Evans
Conservative MS James Evans

Pointing out that Betsi Cadwaladr Health Board has been “trapped” in special measures for most of the past decade, he told the Senedd: “It is deeply concerning that, once again, we see multiple health boards at levels four and five.”

Mr Evans urged ministers to publish performance metrics, risk assessments and evidence used to assign escalation levels to enable decisions to be properly scrutinised.

He warned focusing on local financial mismanagement of health boards risks ignoring wider, systemic challenges driven by the Welsh Government’s policy and funding decisions.

Plaid Cymru’s Mabon ap Gwynfor agreed with his Tory counterpart about “deeper and more systemic” failures becoming a “constant feature” of the government’s record.

Plaid Cymru MS Mabon ap Gwynfor
Plaid Cymru MS Mabon ap Gwynfor

“Measures that should be exceptional, temporary and used only as a last resort have instead become routine,” he said. “It is the people of Wales who are paying the price for that failure.”

The Plaid health spokesperson said Betsi Cadwaladr Health Board has come to “embody the Welsh Government’s failure to embed lasting performance improvement”.

Mr ap Gwynfor told the Senedd: “This situation suggests one of two things: either the special measures system itself is not working or there’s no ceiling to Labour’s mismanagement.”

Mr Miles emphasised that escalation is about supporting health boards, not punishing them. The health secretary also pointed to challenges in other parts of the UK, with 12 of the 14 health boards in Scotland also in escalation.

South Wales East MS Natasha Asghar outside the Grange University Hospital
South Wales East MS Natasha Asghar outside the Grange University Hospital

Speaking ahead of the Senedd debate, South Wales East MS Natasha Asghar said: “This serious intervention is a damning indictment of Labour’s track record when it comes to the health service here in Wales and it is my constituents who are paying the price.

The Conservative MS continued: “Our dedicated NHS staff go above and beyond day in, day out, often under unimaginable pressure, but they are being let down by the chaos and mismanagement from the Labour Welsh Government.

“The problems within our health service have been known for quite some time, yet it appears Labour politicians in the Senedd are either reluctant or totally incapable of doing anything to fix the system.

“The Welsh Government must now finally declare a health emergency and focus all efforts on improving outcomes for patients, driving down shamefully high waiting lists, and turning our health service around.”

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