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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

Medicine shortages now ‘most severe on record’, health leaders warn

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PATIENTS are facing some of the worst medicine shortages ever seen in the UK, with pharmacists warning the situation now poses a serious risk to safety.

The National Pharmacy Association said shortages affecting commonly used medicines are becoming more frequent, lasting longer, and causing increasing disruption for patients, GP surgeries and pharmacies.

The warning comes as Serious Shortage Protocols for Creon, used by people with pancreatic cancer and cystic fibrosis to help digest food, have been in place since May 2024 and have now been extended until July 10, 2026.

HRT treatment Estradot has also been under a Serious Shortage Protocol since December 2024, with the current extension also running until July 10.

Patients travelling between pharmacies

A survey by the National Pharmacy Association found that 98 per cent of pharmacies had encountered patients who had visited several pharmacies in one day to find a prescription.

It also found that 96 per cent of pharmacies believed the current situation posed a serious risk to patient safety, while 89 per cent said they had been unable to dispense a medicine at least once a day because of supply problems.

Some pharmacy teams have also faced anger and abuse from patients unable to obtain medication.

Olivier Picard, Chair of the National Pharmacy Association, said: “Medicine shortages are becoming more frequent, lasting longer and causing increasing disruption for patients.

“These shortages are some of most severe the UK has experienced.

“It is deeply distressing to find patients who have travelled from pharmacy to pharmacy to find the medicines they need without success.”

Calls for urgent taskforce

The NPA is calling on the government to convene an emergency taskforce involving manufacturers, wholesalers, clinicians and pharmacists.

It also wants changes to rules which currently stop pharmacists from making simple substitutions, such as changing a tablet to a capsule or a cream to an ointment, even where a safe alternative is available.

Professor Victoria Tzortziou Brown, President of the Royal College of GPs, said medicine shortages were frustrating for patients, GPs and pharmacists, and added pressure to already stretched services.

She said the College supported pharmacists being able to make limited changes to prescriptions where a medicine is unavailable and a safe alternative exists.

She added: “The most important thing is that patients are able to access the medication they need safely and without delay.”

The Cystic Fibrosis Trust and Pancreatic Cancer UK have also raised concerns about the impact of shortages of pancreatic enzyme replacement therapy, including Creon, on people who rely on the medication to digest food, maintain weight and stay well enough for treatment.

 

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Health

Woman jailed assaults on police, harassment and XL Bully possession

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A CARMARTHEN woman has been jailed after admitting a lengthy catalogue of offences including assaults on police officers, harassment, breaching a Community Protection Notice, shop theft, possession of an XL Bully dog and assaulting a paramedic.

Tilly Rees, 25, of Llys Caermedi, Carmarthen, appeared before Llanelli Magistrates’ Court on Wednesday (Jun 18).

The court heard that Rees admitted multiple breaches of a Community Protection Notice issued in 2025, including incidents in which she shouted abuse in public, caused distress to residents and repeatedly targeted individuals named in court proceedings.

Harassment campaign

Among the offences was a harassment charge relating to a course of conduct against a Carmarthen man between March and May this year.

Prosecutors said Rees approached him on multiple occasions, shouted abuse, called him a paedophile and video-recorded him and his home.

She also admitted a series of Community Protection Notice breaches linked to the same behaviour.

Police assaults

The court heard that Rees assaulted a number of police officers during incidents in Llanelli on May 1 and May 5.

Several assault charges against serving police constables were taken into account by the court when sentence was passed.

A further charge of assaulting a paramedic at Dafen Police Station on June 12 was also admitted.

Shop theft and XL Bully

Rees also admitted stealing items including sanitary products, deodorant, skincare products and reading glasses from a Carmarthen pharmacy.

In a separate matter, she admitted possessing an XL Bully dog contrary to the Dangerous Dogs Act. The court ordered the dog to be forfeited and destroyed after Rees relinquished her rights to it.

Restraining orders imposed

District Judge M Layton imposed a number of restraining orders preventing Rees from contacting named individuals or referring to them online.

The orders prohibit direct or indirect contact and restrict social media activity relating to those protected by the orders.

Jailed for 26 weeks

Magistrates concluded that only an immediate custodial sentence could be justified.

Rees was sentenced to a total of 26 weeks’ imprisonment.

The court heard that some of the offences were committed while she was already subject to a suspended sentence, while others involved assaults on emergency workers carrying additional aggravating factors.

 

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Education

Senedd Members walk out after Reform MS’s comments

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COMMENTS made by a Reform MS led to a walkout in the Senedd during a debate on the Welsh Government’s international spending.

A Reform motion, calling for an end to all Welsh Government international spending, was rejected by Senedd Members on Wednesday June 17.

Wednesday’s plenary opened with Llywydd Huw Irranca-Davies reminding members to mind their language and tone when contributing, following clashes between Reform UK’s Joe Martin and the First Minister in Tuesday’s proceedings.

Mr Irranca-Davies said: “Robust disagreement is part of democratic debate, but it must always be grounded in respect and we must avoid using language that has the potential to inflame debate or to increase tensions.”

The debate was opened by Reform’s shadow minister for finance and government efficiency, Cai Parry-Jones, but it was the contribution made by Caerdydd Penarth MS Joe Martin which sparked the most controversy.

Reform MS Cai Parry-Jones
Reform MS Cai Parry-Jones

Announcing to his colleagues that he had “good news”, Mr Martin began his statement by sharing that he had “found the £9 million” needed for Plaid’s “childcare idea”.

However, Mr Martin then added that the “bad news” was to get the money the government would have to stop funding “some of the most pointless schemes known to man”.

One example Mr Martin gave of these so-called “pointless schemes” was a beekeeping scheme in Uganda designed to advance gender equality.

The scheme, run by Bees for Development and their partner organisation, The Uganda National Apiculture Development Organisation, aimed to enhance women’s economic empowerment through beekeeping.

It challenged gender norms in the industry, increasing the visibility of women in technical and policy leaderships roles.

Mr Martin then suggested Wales had won the “Who can find the stupidest use of taxpayer money?” competition because of a scheme supporting tree planting in Uganda.

He said: “We actually asked some Ugandan people what they thought about Wales’s scheme to send them money for trees and they said, ‘Why are you sending us money for trees?’

“We then asked the same question to some Welsh students who had been through our underfunded education system, but we didn’t get a reply because we had e-mailed them and they couldn’t read.”

Mr Martin went on to criticise the money spent on mini embassies abroad.

He said: “In India, one of the functions of those mini embassies is to recruit nurses to come and work in our NHS, which is great because it means that the Welsh people who would have otherwise become nurses can instead go on universal credit.”

The Reform MS then added: “I have enquired as to why we can’t just have an enormous pit where we burn all the money, but apparently that’s not compliant with net zero.”

At this point in Mr Martin’s statement Plaid Cymru’s Zaynub Akbar, of Caerdydd Ffynnon Taf, announced she was going to leave the Siambr.

She said: “I don’t accept any of this and I don’t want to be a part of it, so I’ll be leaving the chamber.”

Plaid Cymru MS Zaynub Akbar
Plaid Cymru MS Zaynub Akbar

She was followed by numerous other Senedd Members, including Trefnydd and chief whip Heledd Fychan.

Mr Martin was then reminded by the Llywydd of Senedd rules, which mandate respect in the chamber, before he could continue his contribution.

He concluded his speech to the Senedd by saying: “In Westminster, the Tory party doubled foreign aid whilst imposing austerity. There are now only seven of them in this chamber. The same fate awaits any party that insults taxpayers by frittering money overseas on feel-good vanity projects.

“So, I want to encourage the Party of Wales to be nationalist, to put Wales first. Spend your constituents’ money on your constituents. That way, when someone is lying in a hospital corridor and they ask you, ‘are you really the Party of Wales?’, you’ll be able to say ‘yes’.”

At the end of the debate, the Llywydd directly addressed Mr Martin calling for him to “reflect” on his remarks and contributions, noting that it was “not in line with [his] expectations”.

Mr Irranca-Davies described it as “particularly disappointing” given the comments he made at the beginning of plenary.

Senedd Llywydd Huw Irranca-Davies
Senedd Llywydd Huw Irranca-Davies

He said: “Going forward, I think we all need to reflect on this and make sure that we comply with our conduct within this chamber and the way we comport ourselves in light of my remarks.”

Welsh Conservative leader Darren Millar expressed his support for the Reform-backed motion, saying it is a debate about where responsibilities lie.

He said: “It’s very clear that foreign relations, international development are matters for the UK Government, not the Welsh Government, and as a result of that, I believe that we respect devolution and can expect respect for devolution back when we respect the boundaries of our legislative competence and the competence of the Welsh Government’s position as well.”

Welsh Conservative leader Darren Millar
Welsh Conservative leader Darren Millar

Mr Millar highlighted that his party has continuously argued against the development of “mini embassies” and “overseas offices”.

The Conservative leader did clarify however that he is not “anti-international aid”, and noted the “generous” nature of the people of Wales.

But he added: “I do not believe that when people are dying waiting for ambulances, when we’re at the bottom of the educational tree as far as the league table of the United Kingdom is concerned, and when our road infrastructure isn’t working, our transport infrastructure is creaking, that it’s right to spend those millions of pounds on those things, when the Welsh Government should be focused on the things for which it is responsible.”

Taking an intervention from Labour’s Huw Thomas, Mr Millar was questioned on whether he recognises that the majority of international spending is on economic development for Wales.

Labour MS Huw Thomas
Labour MS Huw Thomas

Mr Millar once again referred to the role of the UK Government, noting that it is their responsibility to bring inward investment to the UK as a whole.

He said: “We will always want to be an internationalist country, looking out and seeking to influence the world, but we do that as part of the United Kingdom, an integral part of the United Kingdom.

“And I’m proud to be a member not only of the Welsh Conservative Party, but of the Conservative and Unionist Party, and I believe in the union of the United Kingdom, and that these foreign relationships and international development are done better as a United Kingdom as a whole.”

Plaid Cymru’s Gwyn Williams shared a notably different perspective to that of his Conservative and Reform colleagues.

Prior to being elected to the Senedd, Dr Williams was a consultant ophthalmologist specialising in retina care at Swansea Bay University Health Board.

Plaid Cymru MS Gwyn Williams
Plaid Cymru MS Gwyn Williams

Speaking as someone who has worked within the Welsh NHS Dr Williams said: “Wales has long been a country that looks beyond our own horizons, looking to make a difference in the world and help where we can, but also we rely on help coming in to us as well.

“Many, many healthcare workers, of course, come from abroad, especially here in Wales, and every hospital in the country would crumble if all the international workers went home.”

He continued: “In Singleton Hospital in Swansea, in the eye department, I am the only Welsh-speaking, Welsh-origin consultant there, and much as I like to convince myself that I can do the work of ten people, I cannot, especially now because I am here.

“Chronic shortages in these sectors increase hospital discharge delays, reduce bed availability and create bottlenecks across the healthcare system.

“At a time when the NHS is struggling, we need the support from abroad as well, though we also, of course, need to grow our own ability.”

Concluding his statement Dr Williams said: “This whole debate tries to position international investment and domestic investment as a zero-sum game. It isn’t.

“Looking outwards does not come at the expense of looking inwards. I suggest that such a simplistic outlook condescends to the people of Wales and stymies science.”

Dafydd Trystan Davies, minister for government effectiveness and the constitution

The cabinet minister for government effectiveness, Dafydd Trystan Davies, called for reflection on the tone of the debate, suggesting that the “standard of this debate [had] descended to the level of a public house, not of a national Senedd”.

He said: “My friend the leader of the Welsh Conservatives made a speech, and I disagree with more or less all of it, and yet it was conducted properly and in line with the standing orders and the procedures of this Senedd.

“I think we should all take our duties properly as parliamentarians, whatever views we agree or disagree on.”

Dr Trystan Davies highlighted that international spending makes up just 0.03% of the Welsh Government’s overall budget, which he described as a “small contribution” to “building our prosperity, protecting our public services, strengthening our culture, and promoting our values”.

He said: “Our international work turns that belief into action, creating jobs and investment, exports and partnerships, life-changing experiences for students, new colleagues for our NHS and enabling communities in Wales and beyond to learn from one another.

“When Wales works internationally, Welsh people benefit. Our businesses reach new markets, universities build global partnerships, young people return home with skills and confidence, and Wales’s reputation grows.

“We should be proud of that, not in a narrow way, not with our backs turned to others, but proud to be generous and outward-looking, proud to share, proud to learn – internationalist, not isolationist.”

The motion to end all Welsh Government international spending, tabled in the name of Blaenau Gwent Caerffili Rhymni’s Reform MS Llŷr Powell, was rejected by the Senedd with 37 members for and 48 against.

The Siambr then agreed Plaid Cymru minister Heledd Fychan’s amendment, which proposed the Senedd “regrets Reform UK’s isolationist approach to Wales’s place in the world” and “celebrates Wales’ reputation as an internationalist, tolerant and outward-looking nation open for business, which is enhanced by its international engagement, including spending.”

The amended motion was agreed with 48 in favour and 37 against.

 

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