HYWEL DDA University Health Board has expressed gratitude to local residents after nearly 2,000 people across Carmarthenshire, Ceredigion, and Pembrokeshire shared their views in a major public engagement exercise to refresh its long-term health and care strategy.

The nine-week consultation, which concluded recently, focused on what matters most to people for living healthy lives. The Health Board posed 11 key questions centred on staying well, accessing care, and desired local improvements—including healthcare facilities, community support, and digital services.

These questions were built around four core themes derived from earlier summer feedback:

1. A Social Model for Health and Wellbeing – Exploring how local areas and support networks help people remain healthy.
2. Digital Healthcare Support – How technology can make care more accessible and user-friendly.
3. Balancing Hospital and Community Care – Prioritising wellness within communities.
4. Clinical Services and Hospital Redevelopment – Key priorities for upgrading buildings and healthcare spaces.

The collected feedback will be published in January 2026 and will inform an updated version of the Healthier Mid and West Wales strategy, originally launched in 2018. The core ambitions—enabling people to live healthier lives for longer—remain unchanged, but the refresh will incorporate evolving clinical practices, technological advances, and shifts in how services are used.

Lee Davies, Executive Director of Strategy and Planning, said: “Thank you to everyone who has taken the time to share their views. The direction of travel remains as per our 2018 strategy, so we want to reassure people that this is not a radical change of direction but rather a refinement in how we deliver the strategy.

“Your feedback is helping us reshape our strategy so that it continues to reflect the priorities of the people we serve, and the changes in clinical practice.”

Participants highlighted the vital role of communities, with many emphasising reliance on family and friends for wellbeing and connection. Timely access to GP services emerged as a priority, alongside challenges in travelling to appointments in rural areas with limited public transport. There were also calls for simple, inclusive digital solutions, acknowledging varying levels of technology access and accessibility needs.

At its November public board meeting, the Health Board reviewed progress on the strategy refresh. It also received updates on a new Primary and Community Care Strategic Plan, shaped by further engagement including drop-in events and questionnaires, due for presentation in January 2026.

Additionally, discussions covered a Welsh Government request for an addendum to the 2022 Programme Business Case, examining scenarios for estate improvements and alignment with the national A Healthier Wales strategy, which promotes more community-based care closer to home.

A draft refreshed strategy will be presented to the Board in January 2026 for approval, followed by publication in accessible formats. The Health Board pledged ongoing community involvement, with more opportunities to contribute.

For more details on the engagement process and updates, visit: https://www.haveyoursay.hduhb.wales.nhs.uk/our-strategy

“HARROWING” levels of distress have become the norm for unpaid carers in Wales, a committee has heard, with charities warning of a support system “set up to fail”.

Kate Cubbage, director of Carers Trust Wales, told the Senedd’s health scrutiny committee: “There are too many carers who are reaching crisis point without any support.”

Ms Cubbage explained that most councils are supporting fewer than 500 carers, warning: “There are really, really high levels of unmet need within our communities.”

She told Senedd Members that staff are receiving trauma training to support their mental health due to the levels of distress they are seeing among carers.

Ms Cubbage pointed to a University of Birmingham study which found an increased suicide risk among unpaid carers akin to that of veterans who have seen active service.

“One in eight carers has made a plan to end their own life,” she said, calling for carers to be specifically considered in the Welsh Government’s suicide prevention strategy.

“One in ten has made an attempt… at a time when the average local authority has support plans for less than 0.5% of the caring population.”

Warning of deepening poverty in Wales, the witness expressed concerns about a 31% poverty rate among carers – “far higher” than the 22% in the wider population.

Ms Cubbage added that young carers miss more than six full school weeks each year, compared with pupils without caring responsibilities who miss nearer two weeks.

She told the health committee: “It’s no wonder young carers are achieving less at school. They are less likely to go on into further and higher education.

“And if they do make it to university, they’re less likely than their peers to actually graduate.”

Reflecting on a personal note, Ms Cubbage, a parent carer, said her autistic son has accessed services from ophthalmology to audiology over the past 16 years.

“I have never once been signposted to anything that would suggest that I am an unpaid carer or that I can access support… That kind of lived experience is really important.”

Rob Simkins, head of policy at Carers Wales, added: “Things are getting worse: anecdotally, we see that through our services but also that’s what the research tells us.”

He pointed to a Carers Wales survey which has shown a “shocking” 53% increase in the number of carers cutting back on food and heating.

Giving evidence on Wednesday December 17, Mr Simkins warned of a 39% increase in the number of carers reporting “bad” or “very bad” mental health since 2023.

“All the evidence that we’re collecting shows that this is going in one direction,” he told the committee, adding: “And that’s the wrong direction. It’s a bleak context.”

Mr Simkins said census data shows about 310,000 unpaid carers in Wales but research indicates the number could be nearer 500,000 – roughly 15% of the population.

He cautioned that charities across the country, including Carers Wales, are seeing real-terms cuts in funding from the Welsh Government every single year.

Mr Simkins warned of a “shocking” lack of data and a system “set up to fail” more than a decade on from the then-Assembly passing the Social Services and Wellbeing (Wales) Act.

Warning some councils cannot quantify how many carers’ assessments they could carry out over 12 months, he asked: “How on earth are you meant to collect data from unpaid carers and plan services if you can’t even figure out how many you can assess?”

Asked about carers’ assessments, he highlighted a lack of capacity within councils as he warned a “pitifully low number of carers go on to get any support at all”.

Greg Thomas, chief executive of Neath Port Talbot Carers Centre, told Senedd Members the voluntary sector is being increasingly asked to plug gaps without necessary funding.

He warned the jam is having to be spread “ever-more thinly”, creating a tension between reaching as many people as possible and not wanting to compromise quality of support.

“We’re not quite saying ‘no’ to people,” he said. “But we’re having to say a qualified ‘yes’ about what we’re able to offer… We’re massively overstretched, massively oversubscribed.”

Mr Thomas told the committee the carers’ centre has the required reach and expertise, concluding: “It’s almost give us the tools and we can do the job.”

If you have been affected by anything in this story, the Samaritans can be contacted for free, 24/7, on 116 123, or by email at [email protected].

Public feedback to inform Hywel Dda’s long-term strategy for healthcare delivery

NEARLY 2,000 people across Carmarthenshire, Ceredigion and Pembrokeshire have shared their views on what matters most for living a healthy life, as part of a major public engagement exercise by Hywel Dda University Health Board.

Over a nine-week period, residents were invited to respond to eleven key questions exploring how people stay well, how they access healthcare, and what improvements they would like to see in services, buildings and digital provision. The questions were shaped around feedback gathered from community members earlier in the summer.

The engagement focused on four main themes: a social model for health and wellbeing, digital healthcare support, balancing hospital care with community-based services, and priorities for clinical services and hospital redevelopment.

The feedback will be shared in January and used to inform a refreshed long-term strategy for the Health Board, setting out how safe, sustainable and accessible services will be delivered over the next fifteen years. While the strategy will be updated to reflect changes in clinical practice, technology and how people use health services, the Health Board says its overall ambitions remain unchanged from those set out in the original Healthier Mid and West Wales strategy in 2018.

Lee Davies, Executive Director of Strategy and Planning at Hywel Dda, said the process was about refinement rather than a change in direction.

He said: “Thank you to everyone who has taken the time to share their views. The direction of travel remains as per our 2018 strategy, so we want to reassure people that this is not a radical change of direction but rather a refinement in how we deliver the strategy. Your feedback is helping us reshape our strategy so that it continues to reflect the priorities of the people we serve, and the changes in clinical practice.”

During the engagement, many respondents highlighted the importance of strong communities, with families, friends and local support networks seen as key to helping people stay well and connected. Timely access to GP services was also raised as a priority, alongside concerns about travel to appointments, particularly in rural areas where public transport options can be limited.

Digital healthcare was another recurring theme, with people calling for online services to be simple, inclusive and accessible, while recognising that not everyone has access to technology or the same digital skills.

At its public Board meeting in November, Hywel Dda University Health Board considered progress on refreshing the strategy and received updates on the development of a new Primary and Community Care Strategic Plan. That plan, which has been shaped through further public engagement including in-person and online events and an online questionnaire, is due to be presented to the Board in January 2026.

The Primary and Community Care plan will set the overall direction for services delivered outside hospital settings and support locally-led plans for how care is provided in individual communities.

The Board also discussed a request from the Welsh Government for an addendum to the Health Board’s 2022 Programme Business Case. This will explore additional options for improving healthcare estates, including whether new facilities could help address existing infrastructure problems. It will also consider how local plans align with the national strategy, A Healthier Wales, which aims to shift more care into community settings and closer to people’s homes.

A draft version of the refreshed strategy is expected to be presented to the Board in January 2026 for approval. Once agreed, it will be published in accessible formats, with the Health Board saying communities will continue to be involved as plans move forward.

Further information about the engagement process and updates on the strategy are available through the Health Board’s public consultation platform.