Health
Extension of temporary mental health referral changes in Ceredigion
TEMPORARY changes to the way routine mental health referrals are handled in Ceredigion will remain in place until November 2025, Hywel Dda University Health Board (UHB) has confirmed.
The changes, first introduced in March 2025 to address staffing shortages, mean that patients seeking non-urgent support from their GP are directed to the NHS 111 Wales Option 2 service. This provides access to a local mental health wellbeing practitioner, supported by a registered nurse, offering timely advice, assessment and support.
GPs continue to refer patients with urgent or complex needs directly to the community mental health team. They also have access to a professional 111 support line for additional clinical advice.
Ongoing pressures on local services
The health board has been monitoring outcomes since the change was introduced. With workforce shortages continuing, the arrangement will now be extended to provide stability for patients and staff, while allowing further data collection and analysis.
Liz Carroll, Service Director of the Mental Health and Learning Disabilities Clinical Care Group at Hywel Dda UHB, said:
“Our priority is to ensure people in Ceredigion continue to receive safe, timely and effective mental health care.
“We know there are lessons to learn from this period. As we extend the temporary change, we will work with GPs and service users to address practical issues and ensure the service is as effective as possible. We are grateful for the community’s understanding and support as we face ongoing workforce challenges.”
Thousands living with mental health conditions
Public health data shows that more than 9,000 people in Ceredigion live with common mental health disorders such as anxiety and depression, while hundreds more are affected by bipolar disorder, borderline personality disorder or psychosis.
Although admissions for mental health treatment in Ceredigion have fallen by more than 20% since 2010, experts warn that this reduction may reflect changes in referral criteria rather than a genuine fall in need.
Concerns from the community
A recent survey reported by the Cambrian News found extremely low levels of trust in Ceredigion’s mental health services, with people citing long waiting lists and feeling “badly let down.” Cost of living pressures, loneliness and trauma were identified as major triggers of poor mental health across the county.
An earlier inspection of the North Ceredigion Community Mental Health Team also highlighted gaps in compliance with national standards, underlining long-standing challenges for local services.
Next steps and how to have your say
The Board will review the extension at its public meeting in November, following discussion at the Quality, Safety and Experience Committee (QSEC) in October.
Anyone needing mental health support can contact NHS 111 Wales Option 2, available 24 hours a day, seven days a week. The free service connects callers to a Hywel Dda mental health professional, even if they have no phone credit. GPs remain available for advice and support as usual.
Residents are invited to share their views on the temporary referral pathway at: www.haveyoursay.hduhb.wales.nhs.uk/continued-access-to-mental-health-care-support-in-ceredigion
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Health
Older patients ‘prematurely’ moved to care homes to free up hospital beds
OLDER patients are being “prematurely written off” and discharged into care homes simply to free up hospital beds, a Senedd committee has warned.
Senedd Members found a focus on “patient flow” rather than outcomes meant temporary moves often became permanent, stripping older people of their independence.
John Griffiths, who chairs the Senedd’s local government committee which held an inquiry on hospital discharges, said improving step-down care needs urgent attention.
He warned: “We heard the push to free up hospital beds is often driving older people into residential care prematurely, with no focus on rehabilitation and access to therapy.
“We all know that a hospital is not an appropriate environment for people to recover but neither is a residential home without a focus on recovery.”

The committee was alarmed by evidence of people being “prematurely written off” through the practice of routinely and inappropriately discharging older people into care homes.
Mr Griffiths, the Labour Senedd Member for Newport East, said: “What may initially be seen as a temporary measure often becomes permanent as they lose independence.
“People shouldn’t be removed from acute hospitals into care homes just to free up hospital beds, important though that is.
“They need appropriate intermediate care with therapeutic and nursing input. We need to focus on patient outcomes – not just patient flow.”
He concluded: “To see any real change in hospital discharge, we urgently need better partnership working across health and social care, and greater parity between these important sectors.”
Mr Griffiths expressed disbelief that fax machines and paper-based systems are still being used in 2025, with patient information held on disconnected IT systems.
And Lee Waters, a fellow Labour backbencher, described performance on digital as woeful.

He warned: “Digital Health and Care Wales is behind on progress on all of its major programmes, and is in special measures, and is in complete denial.”
Mr Waters criticised the Welsh Government’s response to digital recommendations for containing “weasel words”, arguing ministers were refusing to mandate best practice.
The former minister said: “The Kremlinologist in me decodes that as, ‘We are not going to do anything different from what we are currently doing’.”
The Conservatives’ Joel James warned of a lack of consistency leading to wide variation across Wales’ 22 councils and even within health board areas.

Mr James told the Senedd: “It is simply not acceptable that people in Wales face a postcode lottery in the care they receive.”
The former councillor also highlighted the plight of unpaid carers, arguing the entire system would struggle to cope without them plugging gaps in provision.
Plaid Cymru’s Mabon ap Gwynfor echoed concerns about a “divided nation”, calling for a national care service to bring councils and health boards together.
He said: “Regional partnership boards look different in one part of Wales compared to another and operate inconsistently across the nation, something that is contrary to the rhetoric of fairness and dignity in care that the government is so keen to highlight.”

Dawn Bowden, Wales’ minister for social care, welcomed the committee’s report and confirmed the Welsh Government accepted all 18 recommendations. She said £30m has been invested this year to boost council services that support hospital discharge.
Ms Bowden rejected claims that paying the sector the real living wage – a Labour Senedd manifesto pledge – was merely “aspirational”, with 84% of the workforce receiving it.
She insisted the government is “holding regions to account” for delivering best practice and would be meeting partners in the coming weeks to ensure improvements.
Ms Bowden committed to a “rapid review of intermediate care practices” to strengthen reablement efforts and help people stay at home.
In closing, she told the Senedd: “Leaving hospital is not the end of care but the start of recovery, independence and a healthier Wales.”

Charity
£2,250 boost for Pembrokeshire dementia services
A MILFORD HAVEN runner has raised more than two thousand pounds for dementia services in Pembrokeshire after completing this year’s Cardiff Half Marathon.
Sam Dolling crossed the finish line on Saturday, October 5, in a time of 1:55:42, smashing his own expectations both on the course and in fundraising. His final total of £2,250 exceeded what he had hoped to achieve.
Sam joked that he had “hounded friends and family via social media” in the run-up to the race – but said the biggest donations came from an unexpected source: friends who still owed him money from a golf trip.
He described the challenge as “rewarding” and said it even helped him stick to a training plan “for the first time ever”.
‘Incredible amount’ raised
Katie Hancock, Fundraising Officer, said: “A big thank you to Sam for choosing to run the Cardiff Half Marathon for Hywel Dda Health Charities and raising money for dementia services in Pembrokeshire, a service that is close to your heart. You raised an incredible amount! Thank you so much for your support and thanks to everyone who sponsored you.
“The support of our local communities enables us to provide services over and above what the NHS can provide in the three counties of Hywel Dda, and we are extremely grateful for every donation we receive.”
For more information about Hywel Dda Health Charities and how to support NHS patients and staff locally, visit their website.
Community
St Florence learning difficulties care home plans withdrawn
PLANS for a care home for adults with learning diifficulties in a south Pembrokeshire village, which raised many local objections, have been withdrawn.
In an application to Pembrokeshire County Council, the Keys Group, through agent Spector Design Ltd, sought permission for a change of use of Quarry Bach, St Florence to a 14-bed care home.
Accomplish, part of the Keys group, is a specialist provider of support for people with Autism, Learning Disabilities and Acquired Brain Injuries.
A supporting statement said, at present, The Haven (Haverfordwest) is Accomplish’s only service in Pembrokeshire, with demand extremely high.
“Quarry Bach will help to address this local demand by providing a dedicated service for people with additional learning needs,” it said, adding: “By doing so, it will reduce the likelihood of individuals being placed far from their home county, family, and support networks, something that can otherwise delay recovery and create unnecessary pressure on both families and healthcare services.”
It added: “The home is intended to provide high-quality, person-centred support for adults who are ready to take positive steps forward in their recovery journey. Many of the people we support want to live in smaller, quieter communities rather than large urban areas, as this often provides the stability and calm they need to rebuild confidence and independence.”
It went on to say: “Placements at Quarry Bach will be commissioned by health boards and local authorities, primarily within Wales. While some people may come from the Pembrokeshire area, others may be referred from surrounding counties where there is a need for high-quality community-based mental health support.”
It stressed: “We want to reassure the community that this is not a large institutional facility but a carefully managed home, designed to help people live fulfilling lives within the community, while respecting the peace and character of the village.”
Local community council St Florence held a public meeting attended by more than 80 people after the plans were mooted, with 80 responses, 54 of them objecting to the plans.
Concerns raised included lack of detail in the application, limited outdoor space, the location being unsuitable, the size of the facility, a potential negative impact on the village, and potential safety issues with several residents stating “they would be afraid of walking alone in the village, and also afraid for their children”.
The application also saw the council’s Social Services & Housing Directorate saying it did not recommend approval as it is not considered there was a need for additional residential care services for 18-65-year-olds; the county having “an oversupply of residential care services for working age adults in comparison with the Wales average,” adding: “If this development is permitted, any demand is anticipated to come from other Local Authorities and Health Boards. An increase in placements from out of area would put further pressure on already stretched local services e.g. hospitals, mental health services, social services etc.”
The application has now been marked as withdrawn on the council’s planning portal.
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